Fighting the Number-One Killer In the US With Data 121
mattydread23 writes "Often, the signs of eventual heart failure are there, but they consist of a lot of weak signals over a long period of time, and doctors are not trained to look for these patterns. IBM and a couple heathcare providers, Sutter Health and Geisinger Health System, just got a $2 million grant from NIH to figure out how better data analysis can help prevent heart attack. But the trick is that doctors will have to use electronic records — it also means a lot more tests. Andy Patrizio writes, 'What this means is doctors are going to have to expand the tests they do and the amount of data they keep. Otherwise, the data isn't so Big.'"
Great use of govt money! (Score:4, Interesting)
This is the perfect use of government money: projects which are promising (though they may not pan out in the end), which will help many people, and which will not be subsidized by industry because they will not make money in the next three quarters. I don't expect any real results from this study for many years, but I think it's a very important study to do.
Re:Great use of govt money! (Score:5, Insightful)
Because every day you benefit from projects that were funded using taxpayer dollars/pounds/euros on the basis of long-term aspirations. The massive investment in road networks, rail networks and telecommunications were all taxpayer funded or subsidized. The technology spin-offs from the space program are benefits that again may never have seen the light of day without aspirational projects.
You benefit from those who walked before you. In return in makes sense to pave the way for those who will walk after you.
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I see no evidence that it's best to develop, say, profitable satellite technology (GPS, communications, etc.) via the gimmicky aspiration to stick an American flag on the moon; rather, it seems that it would be far superior to aspire to such gimmicks via first developing such profitable technology.
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Any government of a large territory and population will necessarily be large, but it really can't be large by contrast to the population it governs. I absolutely agree that it is an important role of any government to build and improve infrastructure, and even funding research that could spawn dozens of new technologies that improve our lives is within the purview of a good government. But it doesn't have to be large to accomplish these things. Perhaps more importantly, our government is far from focused on
Re:Great use of govt money! (Score:5, Insightful)
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Because you can say that for every government thing, fire departments, police departments, military defense.
Maybe you ought to think about that.
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Re:Great use of govt money! (Score:4, Interesting)
Somalia is the result of a failed state, what was formerly known as the Somali Democratic Republic, which was governed under a single-party, Socialist rule. The resulting mayhem has nothing to do with libertarian or anarchist principles, particularly the Non-Aggresion Principle.
In any case, what actually gives you a functional civilization is a large number of individuals trading voluntarily amongst themselves to better their own situations; profit is not merely the transfer of wealth, but rather the creation of wealth.
How much is "my share", anway? Only the price mechanism of a free market can figure that out consistently, adapting to the reality at hand rather than the fantasies of a "noble" bureaucrat.
So, what is "Government", anyway? Any organization—any organization at all—that confiscates resources by threat of strike-first violence is a "governmental" organization. When one such organization becomes a monopoly, we call that organization "Government".
Government is simply a bad company that doesn't go out of business because it is able to confiscate your resources by threat of violence; it doesn't give you the goods and services for which you personally think you are paying, but you have to pay them anyway—it's totally absurd and unconscionable.
It is not a modern value to coerce resources from people by threat of violence. So, in fact, governments are actually the last barbaric vestige of a pre-modern civilization.
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Government should look like a pyramid - the biggest taxes and expenditures should be local, then state, and t
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Somalia is the result of a failed state, what was formerly known as the Somali Democratic Republic, which was governed under a single-party, Socialist rule. The resulting mayhem has nothing to do with libertarian or anarchist principles, particularly the Non-Aggresion Principle.
In any case, what actually gives you a functional civilization is a large number of individuals trading voluntarily amongst themselves to better their own situations; profit is not merely the transfer of wealth, but rather the creation of wealth.
How much is "my share", anway? Only the price mechanism of a free market can figure that out consistently, adapting to the reality at hand rather than the fantasies of a "noble" bureaucrat.
So, what is "Government", anyway? Any organization—any organization at all—that confiscates resources by threat of strike-first violence is a "governmental" organization. When one such organization becomes a monopoly, we call that organization "Government".
Government is simply a bad company that doesn't go out of business because it is able to confiscate your resources by threat of violence; it doesn't give you the goods and services for which you personally think you are paying, but you have to pay them anyway—it's totally absurd and unconscionable.
It is not a modern value to coerce resources from people by threat of violence. So, in fact, governments are actually the last barbaric vestige of a pre-modern civilization.
How ridiculous.Not only is this attitude incredibly selfish (since it reveals a complete lack of interest in other people's welfare), it is virtually impossible to defend economically. Look how badly this minimal-government lark works in practice. Look at how much poverty there is in America, because so many American's are almost dogmatically obsessed with the idea of a small government, and the "freedom" to not fork out for one another's needs. Collective goodwill, expressed tangibly through fair taxation
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Well, you don't get a choice in the matter in any civilized* country, libertarian. So Somalia's you only choice; go and make your own country.
*By my standards, presumably not yours
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Somalia is the result of a failed state, what was formerly known as the Somali Democratic Republic, which was governed under a single-party, Socialist rule. The resulting mayhem has nothing to do with libertarian or anarchist principles,
What does it even mean to talk about a "failed state" if you don't even want state actors with police power?
In any case, what actually gives you a functional civilization is a large number of individuals trading voluntarily amongst themselves to better their own situations; profit is not merely the transfer of wealth, but rather the creation of wealth.
Which utterly ignores the basic issues of public goods and externalities that have already been brought up. Yes, markets and trade is important. But we have theorems and empirical data about when markets work and when they don't. High transaction costs with large externalities (either positive or negative) or with public goods aren't those circumstances. There's no way to do large-scale medical resear
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Yes, Somalia is the result of a government going away and being replaced by whoever comes along. Surely the Anarchists and Libertarians of the world could re-model Somalia to suit them. It's not like there's a government there now to object. It's also not like the kind of people making Somalia into a hellhole wouldn't eventually show up to trouble a Libertarian or Anarchist state.
Meanwhile, in places where governments aren't as strong, corporations most certainly hire violent goons to coerce people. They wo
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corporations most certainly hire violent goons to coerce people
Then those corporations are are governmental organizations; that is, you're saying that at worst , you end up with government.
Somalia is the result of a government going away and being replaced by... the kind of people making Somalia into a hellhole
Actually, in areas of civilization where governmental organizations (including warlords) have not been terribly imposing, Somalia has shown massive improvement even compared to the surrounding countries that have relatively stable governments; the collapse of an unworkable, savage organization like the "government" of Somalia was probably the best thing ever to happen to Somalians d
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Then those corporations are are governmental organizations; that is, you're saying that at worst , you end up with government.
I think I hear bagpipes playing. What you end up with is the worst sort of government. One that genuinely doesn't vare is anyone not on the inside lives or dies. One that doesn't even pretend to believe you should have a say. I'll pass on that one.
If Somalia is such a paradise, why then are the libertarians so loath to go take the place over and leave the rest of us alone?
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The ability of a government to enforce its will is the root of its power, but I challenge you to come up with a sustainable circumstance under which a broad population of humans can exist without organizing somehow, whether voluntarily or involuntarily. Even a Commune requires a hierarchical structure. Stripped of government, people will still group together. Some of those groups will be dominated by the most aggressive member, while others will organize themselves more amicably (and eventually dominated by
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What in the world are you going on about? The issue isn't organization; the issue is voluntary interaction vs involuntary interaction (as you yourself hint). "Anarchy" does not mean "without order"; indeed, it is the price mechanism that yields order without the need for central planning, which is impossible anyway.
For the record, enforcing rules to which people have already agreed is voluntary interaction—and No; just because a large group of people agrees to something does not mean that every indivi
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And how do you propose to get 7 billion people to agree on any one thing? It can't be done. You'll have a hard enough time doing it with just 100 people, let alone the entire population of a region. This is why we have leaders. Leaders can make decisions that get followed. When that breaks down, that leader ceases to be such. Majority rule is the only thing that really makes any kind of sense.
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And how do you propose to get 7 billion people to agree on any one thing? It can't be done.
Exactly. It can't be done; authoritarianism is doomed to engender strife and failure—regardless of whether or not that authority is one man, a group of men, or slightly more than half a population.
Majority rule is the only thing that really makes any kind of sense.
"An absolute Monarch is the only thing that really makes any kind of sense" said very many myopic people at one point.
What if the majority says that I must eat peas? That doesn't sound like it makes any kind of sense at all.
Put another way: If you like peas, then you go right ahead and purchase them; I'm not
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This is a terrible idea. Allow me to explain how this will actually work in practice. Doctors will be given a massive set of questions to ask (but they won't be paid more for the extra time it takes to ask them), they will be given a new set of tests to run (wasn't the point of this to cut healthcare costs?), and they'll have to switch to fully electronic medic
Physician heal thyself (Score:1)
ADon't lie to your doctor. If you don't want to answer, fine. Just say so. If you don't want to take a pill, just say so. But it's impossible to help you if we don't know the truth.)
If you don't want patients to lie to you, then you should start by not lying on our charts. If we say we don't want to answer the question of whether we smoke, don't write down the lie "patient smokes." If we say we have a glass of wine on Friday nights, don't write down the lie "patient is a moderate drinker."
You assholes have decided that every patient lies (under reports healthy behaviors and over exaggerates pain) to you that you've left those of us who were telling the truth no choice but to lie so tha
Drinking in moderation (Score:2)
If we say we have a glass of wine on Friday nights, don't write down the lie "patient is a moderate drinker."
Huh? I don't get it. Is one glass of wine a week not drinking in moderation?
What label would you have used instead?
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Ah yes, the old fire and police argument. Guess who runs those? Hint: unless you live on a military base or in DC, it's not the federal government.
The response about police, and fire was in regards to mfwitten's essentially anarchist claim, not a general defense of a federal government (different government systems work). But you'll note that my comment listed three things, police, fire and military. Moreover, the federal government is heavily involved in police activities: the FBI is one of many examples that functions doing what amounts to police work. Whether the specific matter discussed by TFA is a good idea or not is a *distinct* issue which cou
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Ah yes, the old fire and police argument. Guess who runs those? Hint: unless you live on a military base or in DC, it's not the federal government.
This is a terrible idea. Allow me to explain how this will actually work in practice. Doctors will be given a massive set of questions to ask (but they won't be paid more for the extra time it takes to ask them), they will be given a new set of tests to run (wasn't the point of this to cut healthcare costs?), and they'll have to switch to fully electronic medical records of the sort that don't really exist today - the kind where every diagnosis a patient has is properly coded in ICD-10, along with initial diagnosis dates, therapeutic intervention, and outcome.
Amazing that these systems work in Canada, Australia and the UK and for less than the US government OR public spend on healthcare.
And of course you want the data to be mined, that's how we find the main causes of common medical issues and can implement defences against them (prevention is better than cure).
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I don't expect any real results from this study for many years, but I think it's a very important study to do.
Great. Then you pay for it. I don't share your enthusiasm, so why should I have to share your bill?
See now I, and a lot of the rest of the so-called "First World" completely fail to comprehend this attitude from Americans. I find it laughable to be quite frank. Why the hell do you not want to look after your fellow people?
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Why are you putting words in my mouth?
I do want to look after my fellow people; however, I don't necessarily agree that your ideas for doing so are the best ideas, let alone good ideas at all. Why should I be forced to pay for your ideas? I'm not your slave.
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Hey I'm sure lots of ideas YOU HAVE that I think stink are getting money, too. We don't always get what we want. But we all chip in a little so everyone's ideas get a fair shake. Sorry you don't like it. You could always leave.
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Conservative and libertarian americans are really desperate to hand over world's leadership to China. I'm from Mexico,you would be tempted to guess that americans would want to know why my country is almost a failed state and South Korea that was a very similar country to Mexico 30 years ago -development wise- no. We have implemented many of those "small government" ideas, and now we have to bury our neighboors and double check if the trash bag on the street is really a trash bag or it is filled with a muti
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I don't expect any real results from this study for many years, but I think it's a very important study to do.
Great. Then you pay for it. I don't share your enthusiasm, so why should I have to share your bill?
Cool. I pay for my share of the heart disease thing -- that killed a thousand or two people on 9/11, and every other day before and after that -- and you get "terrorism". Deal?
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I don't expect any real results from this study for many years, but I think it's a very important study to do.
Great. Then you pay for it. I don't share your enthusiasm, so why should I have to share your bill?
The biggest obstacle to health is Big Pharma's death grip on politicians. How many cures are tossed to the wayside because there's no profit in it?
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I agree! Not only that, the number one killer is accidents. Typical /. all wrong all the time.
Not even remotely close [cdc.gov]. Typical AC. Just typing "causes of death in us" in google would've got this answer in the number one slot.
Re:Great use of govt money! (Score:5, Interesting)
It's also the perfect segue into Total Informational Awareness. It's basically data mining. You find a couple of soft indicators - the patient starts complaining of shortness of breath perhaps, has hypertension, is overweight. Then he moves. Starts over again. Doc asks the same question, patient puts down different dates (because they don't remember the doc visit five years ago), rinse lather repeat. If you could track this sort of stuff over time the 'computer' could start making some pretty easy correlations.
IF you had the data. And only IF you had the data. Which means linked EHRs. Which is an interesting concept and would likely help, except, given the current state of our Panopticon Plus government, you have to wonder exactly who they are trying to help.
Comrade.
Oh, AND IT'S HEART FAILURE NOT HEART ATTACK. THEY'RE DIFFERENT. If you're the editor at least glance at TFA. /pedant /normal blood pressure mode
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This is the perfect use of government money: projects which are promising (though they may not pan out in the end), which will help many people, and which will not be subsidized by industry because they will not make money in the next three quarters.
I know that "companies can't see past the next quarter" is a popular notion, but it does not apply to all industries.
Big Pharma & medical device companies spend plenty of money on R&D that has no guarantee of paying off.
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Perfect use of government money would be to help people eat healthier food and exercise regularly.
Subsidize local fruits and vegetables, offer cheap yoga lessons across the country, and you'll soon won't have to monitor as many hearts.
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No, perfect would be if they did both. Promoting healthy living would lower the incidence of heart disease, but a lot of people would still get it.
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This is the perfect use of government money: projects which are promising (though they may not pan out in the end), which will help many people, and which will not be subsidized by industry because they will not make money in the next three quarters. I don't expect any real results from this study for many years, but I think it's a very important study to do.
While I agree with your premise that this is the perfect example of why we would want government to fund specific types of R & D, I'd argue that private industry is terribly interested in analytics and the ability to provide enhanced clinical decision support and measure previously unknown positive outcomes based on specific treatment protocols or inputs.
HIT companies have saturated the existing EHR market - competitive advantage will come from the ability to derive value from existing data.
Waste of money (Score:4, Interesting)
If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet. This knowledge is not new; this stuff has been known for almost a hundred years now, yet we're still spending money dancing around the fact that eating animals and their byproducts leads to heart disease.
Source: http://www.plantpositive.com/ [plantpositive.com]
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Re:Waste of money (Score:5, Interesting)
Utter rubbish. The French eat meat and have a high fat diet, but have a very low incidence of heart problems
Your link is to a fad-diet site.
Re:Waste of money (Score:4, Informative)
Utter rubbish. The French eat meat and have a high fat diet, but have a very low incidence of heart problems
Your link is to a fad-diet site.
I think they consume far less sugar and soda and more fiber, which may explain things. You might find these two (long) talks interesting. The first is research/study based, the second is more anecdotal, but with some research. I thought they were both excellent and interesting.
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They probably consume much less soda pop (and not high fructose corn syrup in lieu of cane sugar), but french use love sugar in their baked goods. they also drink a lot of wine. maybe the wine explains something
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Some of you younger punks who didn't live through the beginnings of the anti-fat craze in the late '70s and early '80s wouldn't have seen things like Entenmens release strudels and whatnot which were "fat free". They took out the fat and added extra amounts of sugar, essentially crystalizing it, making it palatable.
I am positive the anti-salt craze has contributed, not in the way people think, but in making food less tasty, and thus people eat more of it. More of what? Carbo foods.
200 of the 500 calories
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Utter rubbish. The French eat meat and have a high fat diet, but have a very low incidence of heart problems
Your link is to a fad-diet site.
Ah, the French Paradox. Not sure whether that is actually valid:
http://en.wikipedia.org/wiki/French_paradox#Theory_that_the_French_paradox_is_a_statistical_illusion [wikipedia.org]
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No, it isn't. (Score:1)
If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet.
That helps to reduce the risk, not prevent heart disease. That's something that makes me cringe - this idea that diet is a panacea for one's ills. Lately, the vegans (Engine Co. 2 for example) have been proselytizing their way of life and selling it by over stating the health benefits. When I see folks who claim that their cancer was cured by switching to a vegan diet, I just think of all the other reasons why they were "cured" - the cancer going away when she switched to a vegan diet was most likely just a
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If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet.
That helps to reduce the risk, not prevent heart disease. That's something that makes me cringe - this idea that diet is a panacea for one's ills. ...
Genetics also have a lot to do with it, too.
Yes, eating more plants and less animals (even fish) is better for our health, our ecosystem, and our wallets, but let's not over state the benefits, please.
Not your wallet. Check out the prices in the produce aisle some time. Meat is often a cheaper source of your necessary nutrients than vegetables.
When we talk about vegetarian diets reducing your heart disease risk, it's frankly irresponsible to not provide information about how much it reduces the risk. There is an answer: 32%. http://abcnews.go.com/blogs/health/2013/02/04/vegetarians-have-lower-heart-disease-risk-study-finds/ [go.com] That's significant enought to take into account, and not even close to enou
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As a generalization, there's some truth to this, but it's not as clear cut as all that. Some vegetarians are so because they have personal qualms about eating animals or eat a vegetarian diet because of their religion. Those are the best vegetarians to study. They are not as prone to nutrition fads that encourage them to eat or drink 20x normal amounts of specific foods (e.g. http://www.drugstore.com/natures-answer-sambucus-black-elder-berry-extract-super-concentrated/qxp290049 [drugstore.com]).
The subsidized food pyramid (Score:3)
"Meat is often a cheaper source of your necessary nutrients than vegetables."
Ignoring how meat does not have essential phytonutrients in it (as you mention), consider the political reason of why that is the case as far as "calories":
http://www.seriouseats.com/2007/11/the-subsidized-food-pyramid.html [seriouseats.com]
"The Physicians Committee for Responsible Medicine has posted an easy-to-understand visual on its site that shows which foods U.S. tax dollars go to support under the nation's farm bill. It's titled "Why Does a S
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So bunny rabbits are immortal?
Who knew?
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That's because 99.9% of Bunny Rabbits die of STDs...
DUH!
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i eat plenty of saturated fats, meat and cholesterol and at almost 40 my cholesterol is less than 200
the secret is to stop eating processed foods and eating meals out. i stopped eating out at lunch and bring my lunch from home that my wife cooked fresh
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That's great that you eliminated processed food. Try to get your total cholesterol under 150. This page[1] mentions the Framingham Study[2], which showed that "only patients with cholesterol levels of less than 150 milligrams per deciliter (mg/dl) achieve the lowest coronary artery disease risk. In the first 50 years of the Framingham study, only five subjects with cholesterol levels of less than 150 mg/dl developed coronary artery disease. Rural residents in the developing areas of Asia, Africa, and Lat
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I have mod points and it took every ounce of my being to not abuse them on this post. There is no '-1 Disagree"...
Seriously, though. A plant based diet can and does work, but it's needlessly difficult if you don't have any ethical hangups about animal products. That is, in order to fill the nutrient gap left by omitting animal products you have to do a fair bit of globe trotting to import all of those plants capable of doing so. This can be prohibitively expensive and is really not something that would have
In general, good points (Score:2)
There are disagreements on the effect of starch on health, one being between Dr. Joel Fuhmran (advocating more calories from leafy green vegetables, other non-starchy vegetables, and beans) and Dr. John McDougall (advocating calories more from starchy plants like sweet potato and whole grains, in part on pragmatic grounds). Even as they both agree that starch should be the basis of calories for humans. See:
http://www.lanimuelrath.com/diet-nutrition/mcdougall-vs-fuhrman-notes-for-you-from-the-great-plant-bas [lanimuelrath.com]
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I have mod points and it took every ounce of my being to not abuse them on this post. There is no '-1 Disagree"...
There is "Overrated." It's generally considered "close enough."
proven wrong (partially) (Score:2)
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It's not meat that's the problem.
It's too much sugar, too much fat, too much salt and too few exercise.
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It's not meat that's the problem. It's too much sugar, too much fat, too much salt and too few exercise.
Some doctors agree w/you. See the "Sugar: The Bitter Truth" link in my previous post [slashdot.org].
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Or just eat a healthy balanced diet at or below your TDEE, and work out regularly. Moderation in everything and all that.
I find that just being active goes a long way towards having good heart health. Now, obviously, people with perfect eating habits and workout schedules still get heart attacks, but on average, there are enough studies showing that good and active health habits (eating right, not smoking, working out) correspond to good heart health.
Moderation does not mean that you stop eating everything
So true: reverse heart disease, not predict it (Score:2)
http://www.drfuhrman.com/disease/HeartDisease.aspx [drfuhrman.com]
http://www.heartattackproof.com/ [heartattackproof.com]
Don't let the naysayer comments get you down.
Also, if arteries in you heart are all clogged up, then what about arteries in you arms, legs, liver, and brain? Cardiovascular disease affects every system in the body -- it is just that heart problems tend to be more tragically obvious than other clogs. So, the best approach is not to unclog a little part of the hearth that will just clog back up soon, but to unclog everything by
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If you want to prevent heart disease, stop eating saturted fat and cholesterol and stick with a low-fat whole-plant-based diet. This knowledge is not new; this stuff has been known for almost a hundred years now, yet we're still spending money dancing around the fact that eating animals and their byproducts leads to heart disease.
Source: http://www.plantpositive.com/ [plantpositive.com]
For me, becoming a vegetarian actually resulted in significant weight gain, increased blood pressure, higher blood glucose and higher cholesterol. My fat consumption, particularly saturated fats, decreased dramatically but I got the opposite effect that orthodox nutrition says I should. Increasing fat consumption, including milk and egg fats brought all those numbers back to normal -- I'm guessing the milk and eggs are what you're calling "animal byproducts".
I guess I practice a "low carb" vegetarian diet.
Old age is a killer (Score:1)
Wouldn't it be better use of our resources to combat the "killers" of people in their twenties and thirties? Those killers being suicide, homicide, and "accidents."
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It would be 'better use of our resources' if we didn't do anything. Just stand back and make money for the corporations. That's all we really are supposed to do, right?
Besides, dead young people are better sources of organs for all of those really important people who help corporations make money.
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why bother with the suicides and homicides when the accidental death rate is more than 2.5x either one?
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That's a false choice. We can do both and one doesn't interfere with the other.
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Furthermore... Accidents, by definition, happen accidentally. If you could prevent them, they wouldn't have happened.
As for suicide - If someone wants to die - Let 'em. Someday, if we don't get hit by a bus first, we all end up dying of something, and a great many of those somethings hurt. When
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Furthermore... Accidents, by definition, happen accidentally. If you could prevent them, they wouldn't have happened.
Just because something is an accident doesn't mean it couldn't have been prevented. For example, there's a lot that has been done (and could be done) to prevent car accidents... Putting soft surfaces on playgrounds helps prevent accidental deaths and injuries from falls... Fire safety codes help prevent accidental fire deaths... And so on.... a huge amount of money is spent each year in direct and indirect costs of preventing accidents.
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If people are prevented to die... (Score:1)
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Fight Club (Score:1)
Don't believe the salesman's hype (Score:5, Informative)
It is a hypothesis that collecting more data will find a pattern that will predict heart failure earlier, and that will lead to earlier interventions.
They haven't demonstrated that it works.
In order to demonstrate it, they have to do a controlled trial. They have to use these data collection systems in a group of 5,000 patients, and use the usual methods in another 5,000 similar patients, and see if there's any difference in a meaningful outcome. Do the patients live any longer? Are they any less likely to get strokes?
Sometimes it works, sometimes it doesn't. The New England Journal of Medicine just published a report on the use of a high-tech surgical intervention -- implanting cardiac resynchronizing devices in a new subset of heart failure patients. http://www.nejm.org/doi/full/10.1056/NEJMoa1306687 [nejm.org] It turned out the resynchronization patients had more deaths than the control group, and they stopped the study early. You don't know until you've done the randomized, controlled trial. That's the method of science, the experimental method. You take your brilliant ideas and put them to a test.
That's science. Everything else is bullshit.
There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.
EMR replaced a simple, effective system -- paper and pen -- with a more difficult system. What's the point?
Read what doctors are actually saying about electronic medical records, http://www.kevinmd.com/blog/ [kevinmd.com] http://www.nejm.org/ [nejm.org]
There are systems that actually make it easier to treat patients. As I understand it, the Veterans Affairs and Kaiser Permanente have systems that actually collect useful data. The Scandinavians have great useful databases. http://www.bmj.com/content/347/bmj.f5906 [bmj.com] But a lot of the new systems, particularly the ones that are merely being installed because they're required and subsidized under new federal regulations, are driving doctors crazy. They complain that they have to log in, go through screens, fill out checklist after checklist, and wind up with records that go on for hundreds of pages that nobody ever looks at again. Traditionally, on paper, they were forced to write a concise narrative for their colleagues and themselves, of useful information that got to the point and helped them make a decision about what to do next. These poorly-designed EMRs stopped forcing doctors to think. It simply forced them to collect a lot of data. Data isn't information. Useless data is noise.
And maybe most of all, they complain that instead of looking at their patients, they're looking at a computer screen. If you have to tell somebody that he's going to die in 6 months if he doesn't stop smoking, you shouldn't be looking at your computer screen. Maybe there's an element of human communication that computer nerds don't appreciate.
In any computerized records, there's a tradeoff between how much data you collect, and how much time you have to spend entering data. You can spend an extra hour a day just entering more data. Is this pill a tablet or a capsule?
And more important than time, when you write a medical record, you should be filtering information for just the important information. Otherwise you're just adding noise to the record, and making it harder for the humans to spot patterns.
If you want to prevent heart failure, the basic job is to stop smoking, lose weight, and exercise. When patients get outside of certain well-understood parameters, you can give the
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There was a study of using an electronic medical record in a pediatric intensive care unit. The patients with the EMR had a higher death rate than the control patients. The doctors said that when they needed to write a prescription in a hurry, they would just take out their Rx pad and write it. When they needed to write it with the EMR, they had to sign in, go through screens, and find what they were looking for.
Do you have a link to that? I would like to see it.
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Do you have a link to that? I would like to see it.
http://pediatrics.aappublications.org/content/116/6/1506.full [aappublications.org]
Unexpected Increased Mortality After Implementation of a Commercially Sold Computerized Physician Order Entry System
Pediatrics Vol. 116 No. 6
December 1, 2005
pp. 1506 -1512
doi: 10.1542/peds.2005-1287
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My endocrinologist is like this, poking at the computer screen for the vast majority of the 20 minutes (!) he sits with me. It's a world built by politicians and bure
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Actually, most of the office systems were originally designed for insurance company billing. Then they tacked on the clinical applications.
We are all Going to die. (Score:1)
ECG iphone app (Score:1)
I just bought this iphone case with built in wireless ecg [cardiacdesigns.com]. Its a little disappointing as I don't get the display thats on the picture. All I get is a notification box that says "normal" with no readouts or gauges, and not even what my heart rate was. Theres an option to turn on prescription mode, but you have to get a prescription from your doctor, scan it, and send it in to the manufacturer. I think this is a good start, but it would be better if it had the option of adding more electrodes and actu
So people don't die of heart disease.... (Score:1)
....or cancer
And they live longer with arthritis, osteoporosis, a failing immune system and dementia. Yeah, sounds like fun.
The Torchwood mini-series "Miracle Day" springs to mind.
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....or cancer
And they live longer with arthritis, osteoporosis, a failing immune system and dementia. Yeah, sounds like fun.
The Torchwood mini-series "Miracle Day" springs to mind.
It's not the first heart attack that kills you, it's the last.
Or to be less snarky, heart disease quite often results in significant extended morbidity before death. Few of us are so lucky to clutch our chests one minute and cut to a graveside service in the rain after the commercial break. And you can have the other stuff you mentioned concurrently, too. Death sucks, but the dying can suck even more.
A lot more than meets the eye... (Score:1)
I work in healthcare, actually for one of the organizations mentioned in the article.
Healthcare organizations have a big incentive to show "meaningful use" to the federal government. The federal government will reimburse healthcare organizations a substantial amount - up to $44,000 per physician under Medicare or up to $65,000 over six years, under Medicaid - if they adopt electronic medical records and show "meaningful use" of those EMRs to improve patient care. (Note: this money doesn't go to physicians
Food (Score:2)
There are a lot fo good advices here "eat healthy food", but few hint of what healthy food is.
Cardiovascular failure is caused by thrombosis. This is a trend of the blood to clog too easily, caused by an imbalance of omega 3 vs omega 6 fatty acids in the food. Fixing this means eating less industrial meat (which concentrate omega 6 since we do not feed animals with grass, but with omega 6 rich corn and soja), and eating a bit more fish.
And you could call it... (Score:2)
...SMART for the heart!
At any rate, I was reminded of SMART for hard drives, which also work by monitoring lots of individual data points over time and trying to detect things which point to a future problem before it occurs.
Heart attacks are not #1 (Score:1)
Nothing worse than poor statistics to make people think whatever it is the government wants us to think. Heart attacks are not the #1 killer in the US. Come on people, DEATH is the #1 killer in the US.
Geez.
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