tag:blogger.com,1999:blog-58739123791018926162024-03-12T15:56:17.611-07:00Health Train Expresscrutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comBlogger818125tag:blogger.com,1999:blog-5873912379101892616.post-55828946039385464202012-01-18T11:06:00.000-08:002012-01-21T07:10:39.129-08:00Mobile Technology Is Transforming The Health Industry<h3> </h3> <h3>Mobile Technology Is Transforming The Health Industry, But To What Extent?</h3> <p><img alt="iphone_health" src="http://tctechcrunch2011.files.wordpress.com/2012/01/iphone_health.jpg?w=288"></p> <p><font size="1">Dave Chase</font></p> <p>Technology is in the process of bringing change to every piece of the health industry — wellness, fitness, healthcare, medicine — you name it. And as it always seems with introduction of new technologies, it’s awe-inspiring how quickly they can transform entire industries yet, at the same time, make us realize just how far we have to go (or how far behind we really are). The health industry has been touched (and defined) by cutting-edge technology for years, yet its relics, legacy infrastructure, paper-pushing, and archaic procedures are as obvious today as ever before.</p> <p>Mobile Technology for health can be classified in two categories:</p> <p><strong>Physician oriented</strong>: Apps designed to access reference materials, calculators, formularies, eRx, EMR remote access, Social Media, Calendaring, email, Video Conferencing, Algorithms</p> <p><strong>Patient oriented</strong>:Health Knowledge Base, Remote monitoring sensors, like <a href="http://techcrunch.com/2011/09/22/basis-reveals-an-awesome-new-affordable-heart-and-health-tracker-you-can-wear-on-your-wrist/">Basis’ heart and health tracker</a>,<a href="http://techcrunch.com/2011/05/24/larks-silent-alarm-and-sleep-monitoring-system-lands-at-apple-retail-stores/">Lark</a>, <a href="http://www.crunchbase.com/company/fitbit">Fitbit</a>, and <a href="http://techcrunch.com/tag/jawbone/">Jawbone’s Up</a>.</p> <p><img src="http://tctechcrunch2011.files.wordpress.com/2012/01/chart-mhealth-1-2012.jpg" width="472" height="356"></p> <p><img src="http://tctechcrunch2011.files.wordpress.com/2012/01/screen-shot-2012-01-16-at-3-32-46-am.png" width="480" height="360"></p> <p>Some mobile apps interface patient and physician, Mobile devices will also change the way that we communicate with our doctors, as physicians may help describe possible treatments or procedures to patients on an iPad using multimedia, visual cues, genomic/anatomical maps, etc., prescribe post-treatment apps to our smartphones so that treatment doesn’t end once you walk out the door of the hospital, or become a conduit for modern communication platforms, a la Skype, that will facilitate remote checkups, treatments, diagnostics, through the phone, or over video. Got a strange looking rash? Take a picture, or scan it on this app. Telemedicine is there in a pinch!</p> <p>All this has developed almost spontaneously with the development of competing hardware devices and software which is open source. and at affordable prices given the size of the patient market. The primary ingredient is innovation, entrepreneurial spirit, and with little governmental funding and/or intrusion.</p> <p>Contrast this with the stuttering acceptance of EMRs and HIEs with government mandates, artificial support with incentive subsidies to support the HIT vendor market. The real beneficiary for CMS’ incentive program are the HIT vendors, not patients, not doctors nor insurers. The data collectors will benefit from the system which will be mined for the benefit of cost containment and perhaps better outcomes.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:614beb53-8e48-4cce-928a-83b3b5589c96" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/health+20" rel="tag">health 20</a>,<a href="http://del.icio.us/popular/mobile+apps" rel="tag">mobile apps</a>,<a href="http://del.icio.us/popular/mobile+technology" rel="tag">mobile technology</a>,<a href="http://del.icio.us/popular/emr" rel="tag">emr</a>,<a href="http://del.icio.us/popular/hie" rel="tag">hie</a>,<a href="http://del.icio.us/popular/hit" rel="tag">hit</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-86703421730669288882012-01-17T10:49:00.000-08:002012-01-21T07:10:39.151-08:00Social Media in a Hospital Bed<p> </p> <p>No this post is not about pubescent hormonal hyper sexuality nor the story about the sex life of fan boys or fan girls, G+strings,, or tantalizing twitter tweepes. It is a story about Fred and Regina Holladay and their experience (bad) when Fred was diagnosed with advanced Renal Cancer. </p> <div style="width: 425px" id="__ss_11109362"><strong style="margin: 12px 0px 4px; display: block"><a title="Dr. to Dr." href="http://www.slideshare.net/ReginaHolliday/dr-to-dr" target="_blank">Dr. to Dr.</a></strong> <iframe height="355" marginheight="0" src="http://www.slideshare.net/slideshow/embed_code/11109362?rel=0" frameborder="0" width="425" marginwidth="0" scrolling="no"></iframe> <div style="padding-bottom: 12px; padding-left: 0px; padding-right: 0px; padding-top: 5px">View more presentations from <a href="http://www.slideshare.net/ReginaHolliday" target="_blank">Regina Holliday </a></div></div> <p>The program is self-explanatory and does not require expansion here.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:4bd3feae-0df5-4787-873a-91196e52d801" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/hospitals" rel="tag">hospitals</a>,<a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/healthcare" rel="tag">healthcare</a>,<a href="http://del.icio.us/popular/cancer" rel="tag">cancer</a>,<a href="http://del.icio.us/popular/twitter" rel="tag">twitter</a>,<a href="http://del.icio.us/popular/facebook" rel="tag">facebook</a>,<a href="http://del.icio.us/popular/Google+plus" rel="tag">Google plus</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-68625784047313232762012-01-17T06:09:00.000-08:002012-01-21T07:10:39.211-08:00Bold New Approach to Funding Medical School Tuition<p> </p> <p><a href="http://lh6.ggpht.com/-UhV1C99FR1I/TxWBG4Sp5EI/AAAAAAAADZQ/gsO6A4WaQHM/s1600-h/image%25255B11%25255D.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-k5rBbKvDBi8/TxWBHUxdhRI/AAAAAAAADZY/5Gb5wTIG-Sg/image_thumb%25255B3%25255D.png?imgmax=800" width="244" height="204"></a></p> <p>Over the past ten years both college and medical school tuitions have increased in some cases four times. This has effected college graduates and physicians. Tuition at the state run UC system in 2001-2002 was $ 3429 and has risen to $13,200 per year. This places an extraordinary debt burden on students at a time when they have little income.</p> <p><a href="http://lh3.ggpht.com/-yzaQ9gHdqeY/TxWBHrC3VqI/AAAAAAAADZg/ak28c_ebnSk/s1600-h/image%25255B2%25255D.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-nuneOUGiPiI/TxWBINGKSvI/AAAAAAAADZo/VP_mqABfsc8/image_thumb.png?imgmax=800" width="226" height="231"></a></p> <p>In California which has faced the perfect storm of decreasing revenues in the face of economic distress Chris Occasion, President of the FixUCR movement at the University of California presented a manifesto</p> <p>Their manifesto is the UC Student Investment Proposal, which calls for eliminating the upfront costs of college and having working graduates pay<u> 5 percent of their salary back to the system for 20 years.</u></p> <p>The idea was conceived by students, and although designed for the UC system could very well be adapted to other states and private universities.</p> <p>The investment proposal concept has captured the attention of the Board of Regents of the UC system and was a concept previously studied and discussed by Robert Reich former Secretary of Labor under the Clinton Administration. He presented a similar idea in 2008 for California’s mounting fiscal stresses. Economists at the time termed the financial plan feasible however it was deemed politically undoable. This would not be the same for privately funded schools of higher education.</p> <p><a href="http://lh3.ggpht.com/-CrZI0hC58VQ/TxWBIYHktMI/AAAAAAAADZw/B0HUjK0vs38/s1600-h/image%25255B5%25255D.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-NAw9D7yY5xE/TxWBItRM5LI/AAAAAAAADZ4/9t6ESFTNj1I/image_thumb%25255B1%25255D.png?imgmax=800" width="229" height="229"></a></p> <p>A similar perfect storm has developed in health care and medical education which is even more expensive and extended eight years up to twelve years. And while college graduates may complete undergraduate education with a $100,000 debt load, some physicians will exit from medical student and</p> <p>training with up to <u>$ 250,000 debt</u>. <a href="http://lh6.ggpht.com/-MQBr9J_swNU/TxWBJHfAYLI/AAAAAAAADaA/CsqFP2kih5M/s1600-h/image%25255B8%25255D.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-EeZrkmn5TZQ/TxWBJT6FYBI/AAAAAAAADaI/aVP8E-68nMM/image_thumb%25255B2%25255D.png?imgmax=800" width="234" height="223"></a></p> <p>Health reform promises two events, more insured patients, decreased reimbursements and a shortage of primary care physicians (family physicians).This will decrease ability for physician graduates to repay education loans. Adjusting payment rates as a percentage of income adjusts for future changes in income. </p> <p>Many well qualified students rule out medicine as a career because of it’ prospect of prolonged poverty and what often appears to be insurmountable debt. Some highly qualified students will change career goals </p> <p><font size="1">ref: Zimmerman, Riverside Press Enterprise.com</font> </p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:1d9be35d-f4b1-4749-b9cb-1d17f818c145" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/college" rel="tag">college</a>,<a href="http://del.icio.us/popular/tuition" rel="tag">tuition</a>,<a href="http://del.icio.us/popular/loans" rel="tag">loans</a>,<a href="http://del.icio.us/popular/debt" rel="tag">debt</a>,<a href="http://del.icio.us/popular/primary+care" rel="tag">primary care</a>,<a href="http://del.icio.us/popular/physician+shortage" rel="tag">physician shortage</a>,<a href="http://del.icio.us/popular/education+loans" rel="tag">education loans</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-46921206920803926032012-01-13T06:12:00.000-08:002012-01-21T07:10:39.233-08:005% of patients account for half of health care spending<p><a href="http://lh4.ggpht.com/-Obd3wF8f8hU/TxA73_A4dSI/AAAAAAAADYo/had7y-8yqho/s1600-h/image%25255B3%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh5.ggpht.com/-Dfvl_KUQse0/TxA74aXvJaI/AAAAAAAADYw/oK1PLcQFEWQ/image_thumb%25255B1%25255D.png?imgmax=800" width="347" height="296"></a></p> <p><strong>USA TODAY</strong> reports that 22 % of healthcare spending is from less than 1% of patients.(2009).</p> <p>That's about $90,000 per person, according to the Agency for Healthcare Research and Quality. <a href="http://content.usatoday.com/topics/topic/U.S">U.S.</a> residents spent $1.26 trillion that year on health care. <p>Five percent accounted for 50% of health care costs, about $36,000 each, the report said. <p>Why is this number so important? According to AHRQ the report showed how a tiny segment of the population can drive health care spending and that efforts to control cost should focus on this segment to improve efficiency using new technology, outcome studies, <p>About one in five health care consumers remained in the top 1% of spenders for at least two consecutive years, the report showed. They tended to be white, non-Hispanic women in poor health; the elderly; and users of publicly funded health care. <p>•Sixty percent were women <p>•Forty percent were 65 or older. <p>•Only 3% were ages 18 to 29. <p>•Eighty percent were white. <p>•Only 2% were Asian. <p>The found that Hispanics, 16% of the population in 2009, spent less on health care. Twenty-five percent of Hispanics were in the bottom half of health care spenders, the report showed, while only 7% of Hispanics were in the top 10% of spenders. <p>Next, Cohen plans to look at whether cost-cutting measures make a difference. Beginning in October 2012, the government has told hospitals with Medicare patients that it will no longer pay for patients who are readmitted to hospitals for the same condition soon after being released. Cohen said he'll look at whether that will change the spending averages for people in the top health care cost brackets. <p>Another way of stating this is, “unmarried women” (uninsured) (or Medicaid) and old people on Medicare</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:3c8976ab-45a0-4a7b-9971-6815a3ac1530" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/health+consumer" rel="tag">health consumer</a>,<a href="http://del.icio.us/popular/medicare+reform" rel="tag">medicare reform</a>,<a href="http://del.icio.us/popular/medicaid" rel="tag">medicaid</a>,<a href="http://del.icio.us/popular/usa+today" rel="tag">usa today</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-18489453251591644902012-01-10T20:04:00.000-08:002012-01-21T07:10:39.251-08:00C.E.S. & Health Train Express in Vegas<p> </p> <p><a href="http://lh4.ggpht.com/-76C6cqdse4s/Tw0KOHcSUgI/AAAAAAAADRY/9qk8DZNV3dU/s1600-h/image2.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh6.ggpht.com/-UmqHmGHy23E/Tw0KOc4X9SI/AAAAAAAADRg/ntpWkzhHjeM/image_thumb.png?imgmax=800" width="244" height="165"></a></p> <p>Monday January 9 2012 marked the opening of the Consumer Entertainment Show in Las Vegas.</p> <p>Among the carnival-like presentations both on the exhibit floor and in conference were many medical applications in hardware and software. After all,, medical practices and physicians are consumers.</p> <p>Connectivity is high on the list of presentations.. Physical security of the mobile hand held devices was important, however the real value is the software and data in the device.</p> <p>Consumer oriented health monitors were also on the list:</p> <p><iframe style="width: 333px; height: 224px" height="315" src="http://www.youtube.com/embed/tiF9iPQyCO0" frameborder="0" width="560" allowfullscreen></iframe></p> <p><a href="http://www.zensorium.com/" target="_blank">This one is from Zensorium.</a> and intended for iOS. (iPhone)</p> <p>RFID for security is available with small tags on laptop cases, smartphones, iPads and the like “Tags” are available for pets and even children to keep them from wandering off. It could even be used for ‘colleagues’ and peers to keep from losing each other even significant others or spouses. (in an extreme case).The potential for use in hospitals is great to locate patients who may be roaming to special testing. Physicians hate going to an empty room when they expect to see the patient.</p> <p>Digital healthcare was no stranger at the CES. From Panasonic to Allscripts medical applications are being mainstreamed even in the consumer retail market place. COSTCO offers the Allscripts My Way EMR which can be purchased at any Costco warehouse. </p> <p>In addition to mobile apps and advances in display technology the merger of automobile connectivity within the vehicle and also externally for safety features are being emphasized as selling points for vehicles</p> <p>Ford, Microsoft, Healthrageous and BlueMetal Architects announced an alliance to research technology to help people monitor and maintain health and wellness while on the move during the “Doctor in Your Car” keynote address at the Digital Health Summit at the 2012 International Consumer Electronics Show (CES).</p> <p>An interesting statistic (Pew) </p> <p>More people now visit online health sites than go to the doctor’s office, making health and wellness the most popular activity on the Web after email and general searches.</p> <p>Social media was also a large component of the CES. Reporters, presenters, and observers were all well connected via email, im, twitter, FB and Google +. Multi-tasking was a necessity on the floor and in the booths. The infrastructure to support this seemed to be better than in most previous CES’ The learning curve from previous event was obvious and the ‘show’ ran smoothly There appeared to be little difficulty with broadband access nor bandwidth. Convention centers seem to have caught up with the never ending growth of demand for wider ‘pipes’.. I watched much of #CES from the comfort of my desk , at C-net, Ustream.tv and Techcrunch,and Twit.tv .</p> <p>It eliminated the challenges of air travel, TSA and DHS.</p> <p><a href="http://lh4.ggpht.com/-he3f1H0N2IQ/Tw0KOjS4LtI/AAAAAAAADRo/ItdNvq4fh50/s1600-h/image5.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh5.ggpht.com/-b9dLhnZIdGY/Tw0KO5wEmkI/AAAAAAAADRw/WPVNIo_VBoc/image_thumb1.png?imgmax=800" width="244" height="115"></a></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:743033fc-26c1-4f38-b066-1398be1b2778" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/%23hcsm+%23fordsync" rel="tag">#hcsm #fordsync</a>,<a href="http://del.icio.us/popular/%23digitalhealth+%23healthit+%23ces" rel="tag">#digitalhealth #healthit #ces</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-89070171874726551882012-01-10T08:08:00.000-08:002012-01-21T07:10:39.347-08:00Senior Citizens on the Health Train<ol> <li><a href="http://www.geripal.org/">GeriPal </a>(blog) <li><a href="http://www.pogoe.org/">POGOe – Portal of Geriatric Online Education</a> (clinical resource) <li><a href="http://itunes.apple.com/us/podcast/geriatric-nursing/id251584168">Geriatric Nursing</a> (podcast) <li><a href="http://www.caregiving.com/">CareGiving</a> (community site) <li><a href="http://www.facebook.com/AmericanGeriatricsSociety">The American Geriatrics Society Like</a> (Facebook group) <li><a href="https://twitter.com/#%21/HealthcareWen">Wen Dombrowski MD</a> (Twitter) <li><a href="https://twitter.com/#%21/AmerGeriatrics">American Geriatrics</a> (Twitter) <li><a href="http://www.appstorehq.com/geripsychconsult-iphone-873959/app">GeriPsych Consult</a> (mobile app) <li><a href="http://www.jhartfound.org/blog/">Health AGEnda</a> (blog) <li><a href="http://www.youtube.com/user/JHARTFOUND?ob=5">John A. Hartford Foundation</a> (Youtube) </li></ol> <p><img alt="SENIORS" src="http://www.modernsenior.net/ksngsnrs.jpg" width="207" height="139"></p> <p>Senior citizens are getting much attention from politicians and health care professionals. Deservedly so since they are the unfortunate who are involuntarily ‘consuming’ health care. It’s the nature of aging and human life.</p> <p>No one wants to be ill or infirm. The term “consumers of health care’ implies that healthcare is produced, or that health itself is produced. Perhaps that is what preventive medicine, healthy diets, exercise, stressful living and a good quality of lifestyle is all about.</p> <p>The list of links at the start of the article is for mature adults and their caregivers. (credits to Bertalan Mesko MD and Webcina. I recommend giving it to you patients. </p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:3aa020d0-a49c-4ae2-9f7e-ab148719de20" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/medicare+reform" rel="tag">medicare reform</a>,<a href="http://del.icio.us/popular/seniors" rel="tag">seniors</a>,<a href="http://del.icio.us/popular/webcina" rel="tag">webcina</a>,<a href="http://del.icio.us/popular/healthtrain+express" rel="tag">healthtrain express</a>,<a href="http://del.icio.us/popular/mesko" rel="tag">mesko</a>,<a href="http://del.icio.us/popular/geriatrics" rel="tag">geriatrics</a>,<a href="http://del.icio.us/popular/nursing" rel="tag">nursing</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-20764737462799409222012-01-07T22:20:00.000-08:002012-01-21T07:10:39.447-08:00Is 2012 The New Era for Health Train Express?<p><img alt="Better Health (TM): smart health commentary" src="http://getbetterhealth.com/wp-content/themes/getting-better-2/images/logo_new.png"></p> <p>Val Jones MD, perhaps the empress of health social media, and Better Health has announced her discontinuation of posting blogs on <a href="http://getbetterhealth.com/" target="_blank">Better Health LLC.</a> She however indicated the continuation of the brand as a platform for Grand Rounds and for her use of it as her personal consulting platform.</p> <p>Dr Jones, along with others, has been a visionary and developed considerable credibility with early backing from <a href="http://en.wikipedia.org/wiki/Revolution_Health_Group" target="_blank">Revolution Health</a> and Steve Case’s interest in health reform. Her success required considerable investment of time, resources and the generous support of many silent investors, physicians, nurses and medical journalists. She innovated aggregation of gifted medical writers into a visible public platform for medical news.</p> <p>There were and are a central core of respected experts contributing to Better Health and these contributors will continue to create content in their own spaces. </p> <p>Thank you to Val Jones M.D. for her effort and success in opening a new vista in communication for patients and providers. I will miss her cartoons.</p> <p>The range of contributors to Better Health include:</p> <p>David Harlow, Dr Wes, Dr. Mike Sevilla, Kevin Pho MD,Lucy Hornstein M.D.,Nicholas Genes M.D.,Steve Novella M.D.,, Tony Brayer M.D., Jeffrey Benabio M..D., </p> <p>Better Health was and is more than a blog. It matured into a digital form of a medical journal, branding itself as an online media company. It has served it’s purpose and will continue in the digital health space, not to be left behind.</p> <p>Many new entities are evolving, such as Social Media Today, Health Works Collective, and many others as the niche matures.these follow the early leadership of <a href="http://www.ihealthbeat.org/" target="_blank">iHealthBeat</a>, and <a href="http://www.californiahealthline.org/" target="_blank">California Healthline</a>.</p> <p>Social media in medicine is evolving quickly and in order to continue our success we must all evolve as it morphs into new delivery methods.</p> <p>I am sure we will hear much more from Val Jones MD</p> <p>Thanks Val.</p> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-31274380273537995382012-01-07T12:25:00.000-08:002012-01-21T07:10:39.540-08:00Health Train in the Sunlight<p> </p> <p><a href="http://lh3.ggpht.com/-xLx_T2vZmH8/TwiqTd7FRiI/AAAAAAAADO8/8frHgPDt9cc/s1600-h/image%25255B2%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-5dja5r2Vxp4/TwiqTlP9noI/AAAAAAAADPE/2IAbcienJRc/image_thumb.png?imgmax=800" width="220" height="147"></a></p> <p><b>The Health Benefits of Sunlight</b> <p><b></b> <p>Researchers have started recognizing the importance of sunlight for a healthy lifestyle, recent studies reveal that sunlight renders many health benefits. Apart from Sunlight maintaining temperature and humidity, sunlight plays a significant role in nourishing and energizing the human body. It is also vital in order to get the full nutritional value from food that you consume and it has been proven that getting sufficient sunlight aids in preventing chronic ailments such as seasonal affective disorder (SAD), osteoporosis, mental depression, type 2 diabetes, and cancers affecting the bladder, breasts, cervix, colon, ovaries, prostrate, and the stomach. To put it more succinctly, sunlight serves as the perfect medicinal pill in promoting a healthy lifestyle. <p>One of the prime benefits of sunlight is that it supplies the body with Vitamin D, which not only promotes the absorption of calcium in the gut but also transfers calcium across the cell membranes. This in turn provides strength to the bones as well as contributes for a healthy nervous system by increasing the production of endorphins in the brain. Usually, deposits of cholesterol-like substances known as ergosterol can be found beneath the skin, which gets converted into Vitamin D hormones when the sunlight penetrates the skin. <p>Vitamin D also helps to lower the level of cholesterol in blood, and sunlight can even prevent the growth of cancerous tumors. Studies show that exposing your face to sunlight for 10 minutes every day can provide your body with the Vitamin D that is required for the day. A lack of Vitamin D is associated with a host of autoimmune ailments such as Crohn’s disease, multiple sclerosis, rheumatoid arthritis, and thyroditis. <p>Another significant benefit of sunlight is that it helps in the prevention of infections resulting from bacteria, molds, and viruses. The health benefits of sunlight include the enhancement of the immune system by increasing the count of white blood cells as well as gamma globulin, which is beneficial in warding off viruses and germs and it enhances the capacity of red blood cells in carrying oxygen. <p>According to certain studies, getting adequate sunlight serves as the perfect exercise for the heart, as it enables the body to lower the resting pulse rate and decreasing hypertension, thereby making the heart healthier. Sunlight also provides resistance power to the skin, by avoiding skin diseases such as psoriasis, eczema, and acne problems. Further, getting sunlight is also correlated with the stimulation of the pineal gland, which produces such vital chemicals as tryptamines. <p>Other health benefits derived through the exposure of sunlight are: <ul> <li> <p>Strengthening of cardiovascular system</p> <li> <p>Normalizing blood pressure as well as blood sugar</p> <li> <p>Increased metabolism</p> <li> <p>Aiding in weight loss</p> <li> <p>Ensuring proper functioning of kidneys by eliminating wastes</p> <li> <p>Enhanced liver function</p> <li> <p>Improved digestion</p> <li> <p>Above all, sunshine has that magical power to alter your moods and cheer you up, thereby preventing anxiety and depression</p></li></ul> <p><strong>Despite its advantages, excess exposure to sunlight may be sometimes destructive, as it can lead to ailments such as eye damage, melanomas, and skin cancer. Likewise, over exposure to sunlight may sometimes result in a change in the color as well as the size of the skin, appearance of irregular spots on the face, and itchiness or tenderness to the skin. </strong> <p>In other words, benefits derived from the sunlight depend upon its usage. Methods such as sunbathing and sun tanning are considered effective for getting adequate sunshine, but make sure that you are using a quality after-sun lotion in order to moisturize your skin after sun tanning. Likewise, put on such clothes that cover your arms as well as legs after sunbathing, which in turn safeguard you from further exposure. However the most important thing to remember that an excess of anything, including sunlight, can be damaging to your health.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:862b130c-f4a0-4108-9f76-f09016268430" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/vitamin+d" rel="tag">vitamin d</a>,<a href="http://del.icio.us/popular/sunlight" rel="tag">sunlight</a>,<a href="http://del.icio.us/popular/cholesterol" rel="tag">cholesterol</a>,<a href="http://del.icio.us/popular/hormones" rel="tag">hormones</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-39229235449836275232012-01-07T10:21:00.000-08:002012-01-21T07:10:39.560-08:00Health Train and Winter<p><img alt="Summary Box: Phone app aims to help winter drivers" src="http://l.yimg.com/bt/api/res/1.2/FmnHLKBa2cjE7NRfvy07Bw--/YXBwaWQ9eW5ld3M7Zmk9aW5zZXQ7aD0zNDI7cT04NTt3PTUxMg--/http://globalfinance.zenfs.com/images/US_AHTTP_AP_FINANCIALTIMES/71ed99cf9c3b8000030f6a706700dff9_original.jpg" width="171" height="116"></p> <p>Mobile apps are the big items this year, not only in health care, but in a multiplicity of other niches.</p> <p>When a powerful blizzard ripped through North Dakota last winter, hundreds of drivers were stranded as white-out conditions shuttered interstates statewide.Even in large metropolitan areas sudden and large snow storms can paralyze drivers with other cars close by. The recent Chicago Lake Shore drive emphasizes the fact that this does not occur in only North Dakota. <p><a href="http://lh4.ggpht.com/-voqIgJQh9ZY/TwiNFa3qltI/AAAAAAAADOM/huufY6R4hPo/s1600-h/image%25255B9%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh6.ggpht.com/-672rmLI2ZDM/TwiNFgn_NjI/AAAAAAAADOU/OSDOo8vDwdA/image_thumb%25255B3%25255D.png?imgmax=800" width="197" height="139"></a> <p>That convinced two local software developers to create the Winter Survival Kit app. <p>North Dakota State University's Bob Bertsch and Jake Joraanstad came up with the free program for iPhones and Android smartphones to help motorists prepare for winter driving and when things go badly. <p>One app available through the iTunes app store is a crossover, linking mobile apps for driving and prevention of possible frostbite and even death if isolated by blizzard conditions and being stranded in your car.</p> <p>The application “Winter Survival Kit” can be downloaded for FREE at the <a href="http://tinyurl.com/7ce69bt" target="_blank">iTunes app store</a>. It will function on the iPhone, iPad and also on <a href="http://tinyurl.com/6uh8yl5" target="_blank">Android Phones</a></p> <p><img src="http://images-partners.google.com/images?q=tbn:ANd9GcSwN6mJCIc5SSTWv8Ngpbatkc4dyoYIx2t4wG-t5YzYR8o-52Tcqdk1Kicz:" width="150" height="213"> <a href="http://lh6.ggpht.com/-Y8T7HHCtTl0/TwiNGdOcwDI/AAAAAAAADOc/yvdjtMp5eoU/s1600-h/image%25255B3%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh5.ggpht.com/-XdKcREgugh0/TwiNGrfGEMI/AAAAAAAADOk/3nrCOMnrlGQ/image_thumb%25255B1%25255D.png?imgmax=800" width="144" height="221"></a> </p> <p>This app will help you find your current location, call 911, notify your friends and family, calculate how long you can run your engine to keep warm and stay safe from carbon monoxide poisoning.</p> <p>Version 1.3 update December 2011, and all reviews give it a 4-5 star rating. </p> <p>The application provides instructions for preparations for cold weather survival and what to do if stuck in your car.</p> <p>It also functions as an emergency 911 alert and will supply geolocation information to emergency dispatchers.</p> <p>Other information it can calculate is time until your fuel runs out, and to remind you to check your exhaust every 30 minutes to prevent asphyxiation from carbon monoxide.</p> <p><a href="http://lh5.ggpht.com/-BHNIj443a0o/TwiNIBs873I/AAAAAAAADOs/N0R9ckmxtxo/s1600-h/image%25255B6%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh5.ggpht.com/--2CRM-HdPfo/TwiNIaHXEFI/AAAAAAAADO0/jdXP3zl2_nw/image_thumb%25255B2%25255D.png?imgmax=800" width="244" height="156"></a></p> <p>The application was developed by <a href="http://www.myriaddevices.com/" target="_blank">Myriad Devices</a> and financial support from a grant from <a href="http://www.nifa.usda.gov/">USDA National Institute of Food and Agriculture</a> Smith-Lever Special Needs grants.</p> <p>HealthTrain Express assesses this device as a mandatory one for anyone who drives in a cold weather climate. It’s usefulness may be restricted in areas that do not yet have cell phone availability. If you are on one of the U.S.National Defense Highways (Interstate Highway System) it’s a fairly safe bet you will have cell coverage.</p> <p>The only thing it does not seem to do is make hot coffee….perhaps in version 2.0</p> <p>Remember also that if cell phone strength is week text messaging may still function….use Twitter, SMS or IM.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:f6aafdb5-efa8-43a8-a74a-8a6fcfd1f263" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/winter" rel="tag">winter</a>,<a href="http://del.icio.us/popular/survival" rel="tag">survival</a>,<a href="http://del.icio.us/popular/mobile+apps" rel="tag">mobile apps</a>,<a href="http://del.icio.us/popular/iPhone" rel="tag">iPhone</a>,<a href="http://del.icio.us/popular/android" rel="tag">android</a>,<a href="http://del.icio.us/popular/smartphones" rel="tag">smartphones</a>,<a href="http://del.icio.us/popular/911" rel="tag">911</a>,<a href="http://del.icio.us/popular/geolocation" rel="tag">geolocation</a>,<a href="http://del.icio.us/popular/prevention" rel="tag">prevention</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-13593914457496438282012-01-06T12:34:00.000-08:002012-01-21T07:10:39.655-08:00California Health Budget Slash<p> </p><object width="420" height="245" id="msnbc544dd2" classid="clsid:D27CDB6E-AE6D-11cf-96B8-444553540000" codebase="http://download.macromedia.com/pub/shockwave/cabs/flash/swflash.cab#version=10,0,0,0"><param name="movie" value="http://www.msnbc.msn.com/id/32545640" /><param name="FlashVars" value="launch=45894509&width=420&height=245" /><param name="allowScriptAccess" value="always" /><param name="allowFullScreen" value="true" /><param name="wmode" value="transparent" /><embed name="msnbc544dd2" src="http://www.msnbc.msn.com/id/32545640" width="420" height="245" FlashVars="launch=45894509&width=420&height=245" allowscriptaccess="always" allowFullScreen="true" wmode="transparent" type="application/x-shockwave-flash" pluginspage="http://www.adobe.com/shockwave/download/download.cgi?P1_Prod_Version=ShockwaveFlash"></embed></object> <p style="text-align: center; margin-top: 5px; width: 420px; font-family: arial, helvetica, sans-serif; background: none transparent scroll repeat 0% 0%; color: #999; font-size: 11px"> <p>Governor Brown surprise budget announcements.</p> <p align="left"><font color="#000000" size="2">Major revisions will be made to California’s health safety net, with reorganization and downsizing big government. No doubt this will be unpopular in some circles. This is further complicated by federal mandates for health insurance exchange formation and proposals to use Medi-Cal as a vehicle for uninsured, uninsurable, and poor.</font></p> <p align="left"><font color="#000000" size="2">Expect Chaos</font></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:e1208fa7-5b74-495b-ae50-635c18020ad1" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/medi-california" rel="tag">medi-california</a>,<a href="http://del.icio.us/popular/budget" rel="tag">budget</a>,<a href="http://del.icio.us/popular/Governor+Brown" rel="tag">Governor Brown</a>,<a href="http://del.icio.us/popular/Health+Insurance+Exchange" rel="tag">Health Insurance Exchange</a></div></p> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-21947124422318827922012-01-06T07:02:00.000-08:002012-01-21T07:10:39.746-08:00Unprotected Sex and Fellatio<p><font color="#333333"><u>Warning: This post may not be appropriate for readers under the age of six.</u></font></p> <p>The article is not intended to be discriminatory in terms of sexual preferences, race, creed, color or political preferences.</p> <p>I am expanding upon an article read in the WSJ Health Blog today.</p> <p><img src="http://images1.wikia.nocookie.net/__cb20100209185017/encyclopediagenerica/images/4/46/Wei-xraybj.jpg" width="256" height="197"></p> <p>A recent study reported in the WSJ Health blog discusses the overall slight decline in rates of cancer with an uptick in certain types of cancer. </p> <p>Among the small increases are the incidence of oral cancers (HPV papilloma of the posterior pharynx, malignant melanoma, thyroid cancer, Although the decline in smoking should decrease this incidence it appears that ‘oral sex’ increases the rate for practitioners of this art of karma sutra.</p> <p>I have given up cigarettes, alcohol, marijuana, meth,cocaine but I will not have oral sex withdrawn (pun intended) from my repertoire of pleasurable activity.</p> <p>Several important features of the study were missing, male vs. female rates, unprotected vs. protected sex and whether the study was separated into homosexual encounters or heterosexual encounters.</p> <p>The CDC and Public Health Service have been allotted ten million dollars for this anti-motivational poster, seen on the left below which is somewhat akin to the anti-smoking images seen below as well</p> <p><img src="http://www.demotivationalposters.org/image/demotivational-poster/small/1006/admit-it-predator-vagina-dentata-fellatio-from-hell-demotivational-poster-1276778295.jpg" width="129" height="175"> <a href="http://lh4.ggpht.com/--Ik9ZwieHkI/TwcM_mAKvKI/AAAAAAAADN8/4ECr_P-rhZo/s1600-h/smoking-lip-l%25255B3%25255D.jpg"><img style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="smoking-lip-l" border="0" alt="smoking-lip-l" src="http://lh3.ggpht.com/-xZpZTm9n77Q/TwcM_-3sIvI/AAAAAAAADOE/gxSZo5m3-ew/smoking-lip-l_thumb%25255B1%25255D.jpg?imgmax=800" width="273" height="156"></a></p> <p>P.S Smoking is banned on the Health Train Express, Oral fellatio? That depends….</p> <p>The entire post is offered (tongue in cheek). Oh there I go again with my oral fixations this morning I am having oatmeal with bananas (cut up for those of you with dirty minds…). Hope you enjoy your coffee !</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:110b7ec1-afaf-4275-9ace-72f18ba24f36" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/fellatio" rel="tag">fellatio</a>,<a href="http://del.icio.us/popular/oral+sex" rel="tag">oral sex</a>,<a href="http://del.icio.us/popular/carcinoma" rel="tag">carcinoma</a>,<a href="http://del.icio.us/popular/smoking" rel="tag">smoking</a>,<a href="http://del.icio.us/popular/public+health" rel="tag">public health</a>,<a href="http://del.icio.us/popular/cdc" rel="tag">cdc</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-69423741369939828952012-01-06T06:20:00.000-08:002012-01-21T07:10:39.843-08:00The Dangers of Social Media and Self Diagnosis<p><img alt="Self-diagnosis by search engine leads surfers to fear the worst" src="http://i.telegraph.co.uk/multimedia/archive/01366/cyber_1366077c.jpg" width="266" height="170"></p> <p>I have been a proponent of social media and it’s use to improve healthcare and improving accessibility for patients to clinicians and hospital resources, there are certain caveats and precaution are advised when attempting ‘self diagnosis’</p> <p>In the past ten years innumerable web sites have become available for patients.. Remembered that these sites were never meant to be used in an isolated fashion for <a href="http://en.wikipedia.org/wiki/Self-diagnosis" target="_blank">self diagnosis</a>. They are meant to be educational and as a supplement to professional office or clinic visits. </p> <p>Entering or searching for symptoms both physical or emotional into a web site will list many answers, some irrelevant. These sites can be accessed either before a visit or after a visit to assist you in discussing your condition with your health provider. </p> <p>Today’s both physicians and patients are faced with decreased face-time during the visit. Web sites are a positive influence for both physician and patient when used properly.</p> <p>They provide the patient an opportunity to ask appropriate questions for the health provider on initial visits, and for follow up education especially if the provider educates his patient as to what sites are credible sources as a supplement to the office visit. Patients should discuss their sources with their doctor.</p> <p>Social media also provides relevant and usually accurate information about health information technology advances, not only in EMRs, HIEs but the explosion of mobile apps for their use in non clinical settings, home monitoring and accessing insurance information, geolocation services for emergencies, hospital and offiice wait times, and drug information.</p> <p>2012 promises to be another innovative year of HIT and Health Reform.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:6c6e9868-964c-4409-a542-e9ad384c7e56" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/self+diagnosis" rel="tag">self diagnosis</a>,<a href="http://del.icio.us/popular/internet+health" rel="tag">internet health</a>,<a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/patients" rel="tag">patients</a>,<a href="http://del.icio.us/popular/physicians" rel="tag">physicians</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-48277527197040948592012-01-03T09:09:00.000-08:002012-01-21T07:10:39.864-08:00It’s In Your DNA: Social Media<p> <p>Take a look at the Info graphic below…. This is taking place in a<strong> single minute — </strong>every minute — of most everyday within the digital world…. <p>Still think it’s a passing fad? <p>Still think you do not need to establish some form of digital presence on the healthcare social media stage? <p><strong>—Think again — </strong> <p><img alt="Healthcare Social Media Digital Footprint" src="http://www.howardluksmd.com/public/60-Seconds-online-infographic.jpg" width="415" height="295"></p> <p><font size="1">http://goo.gl/Bwz1d By: Shanghai Web Designers</font></p> <p>Howard J Luks M.D. points out the reasons why physicians should participate in the landscape of social media in his <a href="http://summify.com/story/Tv3VWQIvkHh_H-J2/www.howardluksmd.com/orthopedic-social-media/your-healthcare-digital-footprint-101/" target="_blank">recent post via Summify</a>.</p> <p>Dr Luks message and articulation of the message is so well put that I repeat it here, and give him full credit for this information. It bears repeating in my blog(s).</p> <p>I happen to agree with him. Issues surrounding health care and health reform have become much more public, open and transparent. Physicians must use the medium which is presently gaining momentum to replace printed and rapidly becoming obsolete magazines, newspapers and other forms of advertisement. </p> <p>Let’s face it most studies and experience show the decline of ‘established newspapers, and journals. This is even more apparent in the under age 50 demographic. </p> <p>Dr. Luks points out:</p> <ul> <li>50% of the world’s population is under 30. <li>They do not communicate via e-mail or telephone. <li>Generation Y and generation Z consider e-mail passé. <li>The fastest growing segment on Facebook is women over 55 years of age. <li>SMS, direct messaging, micro-blogging and digital media is fast becoming the chosen communication standard. <li>Drug/Medical related “Likes” on Facebook have skyrocketed. </li></ul> <p>Dr Luks goes on to elaborate:</p> <p>50% of the mobile Internet traffic in most countries is for Facebook. One on five patients flock to Facebook for healthcare information. Imagine what this means for a bad patient experience? The world has gone digital —social media is here to stay. 1 billion people simply cannot be wrong. 85% of people log onto their Facebook account<strong> every single day</strong>. </p> <p>Any news media presently in business already has built or is building a social media presence. <a href="http://twitter.com/glevin1" target="_blank">Twitter</a>, Facebook and <a href="https://plus.google.com/u/0/114503806689722509896/posts" target="_blank">Google +</a> seem to be in the lead of popularity and each has it’s own model which changes almost daily in an effort to capture the most users.</p> <p>Recently I have been in several hangouts on Google + where people have asked for my medical opinion in the hangout. Each of them has expressed their willingness to “waive their privacy rights'” under current HIPAA laws.</p> <p>Physicians are entrenched in patient privacy and confidentiality by their own training and ethics long before HIPAA was passed. Despite this restriction, many patients already waive privacy when they allow their story to be told at grand rounds in presentations, for testimonials regarding treatments, in other media and for other purposes. Does this carry forward for social media?</p> <p>I would like to ask the readership their opinions and experience in this matter? How many of you have been asked this same question, and what have you advised? Would a verbal waiver be adequate or would you require it to be in writing? </p> <p>. </p> <p>What most physicians recognize is that access to a physician (and almost any physician) is restricted by time and distance. Patient abhor our new systems of telephone trees and triage. Numerous times potential patients express their desire to interact on social media or email with their physician even preferring to leave a ‘message’ via email, twitter or Google plus. </p> <p>With the enormous increase in <a href="http://www.huffingtonpost.com/2012/01/01/2012-medicare-debate-is-a_0_n_1178374.html?ncid=edlinkusaolp00000009" target="_blank">‘Boomers’</a> our system is about to be stressed beyond it’s limits unless some creative steps are taken by universal acclaim. We cannot wait for governments to solve problems that physicians and patients are able to address together. The perfect storm of limiting reimbursements, and increasing benefits, and access threaten our health system. The first step has already taken place by eliminating pre-existing conditions, and extending eligibility of children under the age of 25 under their parent’s policies. </p> <p>Physicians should start thinking about setting aside fifteen to thirty minutes a day to devote to patient care via social media. Some are already doing this via secure email or built in secure messaging in their electronic medical record systems. However not all EMRs are created equal and most do not afford this feature.</p> <p>Most patients no longer find a physician through the yellow pages..they search on Google. Google also indexes social media, and blogs. Their entrance to your practice (other than an insurance roster) is already via a search engine, be it BING, YAHOO, or GOOGLE, Twitter and Facebook. Patients can even invite you to a Google Plus Hangout. And these can be one on one.</p> <p>Internet social media is only beginning and will be adapted in ways we cannot yet even imagine. It has already become a commonplace feature of broadcast television, anchor news, and international links between non major news sources for direct news bypassing conventional syndicated news sources such as CNN, FOX, ABC and NBC. It may become a primary source for professional journal news releases.</p> <p><a href="http://tinyurl.com/2bykytd" target="_blank">The American Medical Association has published a statement regarding physicians’ use of Social Media</a></p> <p>Stay tuned…different place, different station and at any time.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:d283e7ba-1f22-4af7-a191-e8cef2f35a99" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/news" rel="tag">news</a>,<a href="http://del.icio.us/popular/socialmedia" rel="tag">socialmedia</a>,<a href="http://del.icio.us/popular/googleplus" rel="tag">googleplus</a>,<a href="http://del.icio.us/popular/twitter" rel="tag">twitter</a>,<a href="http://del.icio.us/popular/facebook" rel="tag">facebook</a>,<a href="http://del.icio.us/popular/internet" rel="tag">internet</a>,<a href="http://del.icio.us/popular/summify" rel="tag">summify</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-87822390641459130772011-12-30T14:18:00.000-08:002012-01-21T07:10:39.888-08:00Resolutions for 2012 on Health Train<p> </p> <p>New Year's Resolution(s) <p><u><b>The words I will try to never use in 2012.</b></u> <p>Transparent,Open Source,Actionable,Ground breaking,Serial entrepreneur,Pioneer,Visionary, Futurist, Venture Capitalist, Killer-App, G4,LTE, Cloud, Outsourcing, iOS, WebOS, Apple, Microsoft, Windows 8, Virus, Trojan, Worm, Ver.n, Friend-unFriend, Timeline, Circle-Uncircle, Social Media, Klout Score, Mashable, Scobleizer, Timeline, Google, Facebook, Twitter, IPO, Start-up, Kindle, Kindle-fire, I (anything),Smartphone, QR codes, Work from Home, Tablet PC, Groupon, Virtual Machine, Wireless, Youtube, Online/Offline, Chrome, Extensions, Add-ons, Hot Tech Trends, <p>Outcomes, Meaningful Use, Incentives, ICD-10, SGR, Disruptive innovation, Physician pioneer, :Physician champion, ONCHIT, HIE, RHIO, <p><u><b>Things I will try to do:</b></u> <p>No more than 6 #tags, No more than 5 @s, No more than 3 hyperlinks/blog post, Clean my gmail archives, review my Facebook app authorizations, Defragment my hard drives, Not update Windows 7 to Windows 8 for at least one year after it is released. Replace my aging router. Replace my aging laptop. And add an iSomething or other. <p>Spread cheer, humor, understanding and humility to all friends, love my enemies, obey my spouse, try to understand my children (now young adults) and remember that was me 40 years ago. <p>There are many more do not does and does, but I have a hand cramp. <p>I declare tomorrow December 31, 2011 as the last day of 2011 (by the powers vested in me?)</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:49bc3aa0-858f-4883-b0e2-93ff447e2f3c" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/resolutions" rel="tag">resolutions</a>,<a href="http://del.icio.us/popular/do's+and+don't's" rel="tag">do's and don't's</a>,<a href="http://del.icio.us/popular/new+year" rel="tag">new year</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-10909408632201050112011-12-30T14:04:00.000-08:002012-01-21T07:10:39.985-08:00Study Predicts Growing Use Of Social Media In Healthcare<p> </p> <p><a href="http://www.readwriteweb.com/archives/study_predicts_growing_use_of_social_media_in_heal.php" target="_blank">Facebook study</a> reveals deeper penetration of social media into healthcare than most would have predicted.</p> <p>Patients seem more willing to adopt social media platforms that healthcare professionals. </p> <p>It seems that patients will classify certain health related problems according to social acceptability, fears of retribution by friends, or employers or merely embarrassment. </p> <p>STDs appear to be highest on the list followed by cancer, neurologic problems such as aging, dementia, or mild strokes and/or memory loss. Some parents do not want their children to know about serious or potentially fatal illnesses..</p> <p><img alt="Screen Shot 2011-12-29 at 8.57.19 AM.png" src="http://rww.readwriteweb.netdna-cdn.com/Screen%20Shot%202011-12-29%20at%208.57.19%20AM.png" width="456" height="418"></p> <p>During my own social media contact with people (not my own patients) they will often inquire about their illnesses and express a desire to contact their physicians office for an initial encounter, even before a telephone contact.</p> <p>Their may be several factors operating. </p> <blockquote> <p>1. It offers bypassing clerical personnel, either by shortcutting a wait on the telephone, via telephone triage. It also offers after hours communications.</p> <p>2. It depersonalizes the initial contact with a non-medical person, who they do not want to know about a personal problem.</p> <p>3. Some have expressed a brief social media contact with the doctor would alleviate anxiety while waiting for an appointment.</p> <p>4. Some perceive a professional social media contact as an act of caring and would offer a means of expressing anxiety, which might facilitate an earlier office visit.</p> <p>5. The acceptance of these forms of communication have been limited by the feds. Ethics have been replaced with law.</p> <p>6..Google + hangouts it turns out is not a secure platform, nor would an application on top of it be secure.</p> <p>7.others</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:b828cb13-9281-4fa2-b5c6-e2bcd2724184" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/Google+plus" rel="tag">Google plus</a>,<a href="http://del.icio.us/popular/twitter" rel="tag">twitter</a>,<a href="http://del.icio.us/popular/facebook" rel="tag">facebook</a>,<a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/%23hcsm" rel="tag">#hcsm</a></div></blockquote> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-52512581837424326272011-12-28T21:37:00.000-08:002012-01-21T07:10:40.008-08:00Going the Distance<p><a href="http://lh6.ggpht.com/-9mk_3ckFOEk/Tvv8nLxyq-I/AAAAAAAADJs/hSESU9Trd3w/s1600-h/image5.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-s5V3gd0EdLY/Tvv8nSLv9GI/AAAAAAAADJ0/QinbU4mQlAE/image_thumb1.png?imgmax=800" width="242" height="216"></a></p> <p>It is more difficult to maintain your privacy if you use the internet, even for something seemingly as benign as email or Google. </p> <p>Google is more ubiquitous than the yellow pages and is far more accessible.There are many analytics engines sweeping Google, twitter, Facebook and other social media for statistics and trends in internet use ranging from your network size, who influences you,who you influence, your areas of expertise and other unmentionables. <a href="http://klout.com/home" target="_blank">Klout</a> is one site that you can access to have some idea of what analytics is capable of assessing about your internet usage. Most of these programs are free with limited functionality but for a price a much more invasive biopsy of your presence is available.</p> <p><a href="http://summify.com/story/TvsgtgIvkHh9BKdp/casesblog.blogspot.com/2011/12/how-to-manage-your-online-reputation-as.html" target="_blank">Caseblogs, Medical and Dental Health Blog</a> has a check list for you to accomplish at least three or four times a year.</p> <p><a href="http://tinyurl.com/cv9nmjk" target="_blank">Here is his recipe for minimizing damage to your online self</a></p> <p><strong>Connectivity</strong></p> <p><u>Real WIMAX,</u> (not 4G that delivers speed but not distance) may deliver on broadband health IT in remote and rural areas of the United States.</p> <p><a href="http://lh3.ggpht.com/-BHnlEtb2580/Tvv8no05qXI/AAAAAAAADJ8/SqkcbIiX94k/s1600-h/image2.png"><img style="background-image: none; border-right-width: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top-width: 0px; border-bottom-width: 0px; border-left-width: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh3.ggpht.com/-JHtq14CtMlU/Tvv8nyPk_II/AAAAAAAADKE/V96XWk7dssI/image_thumb.png?imgmax=800" width="244" height="171"></a></p> <p>The FCC (Federal Communications Commission) is in the process of releasing <a href="http://whitespaceinternet.org/" target="_blank">“white space</a>”, the television analog frequencies abandoned by the fiat of the FCC several years ago. The white space will be used for ‘Wi-Max” a wide area VHF wireless technology that has the potential for a 60 mile radius with one or several broadcast points. While the power limitations are very low and the speeds are low, it will enable much better coverage in rural areas at much lower cost. The adapters are simple and quite inexpensive, the first rendition that has been approved is from <a href="http://www.ktswireless.com/technologies/" target="_blank">Koo Technologies.</a>(KTS) I believe this will enable rural providers and hospitals to tie into the NHIN easily. The first test markets are in Delaware and Washington, D.C., and rural Virginia. <a href="http://spectrumbridge.com/Home.aspx" target="_blank">Spectrum Bridge</a> is an early provider for the technology.The technology requires a <a href="http://spectrumbridge.com/ProductsServices/WhiteSpacesSolutions/Overview.aspx" target="_blank">database</a> search for unused spectrum so that it does not interfere with other users in that portion of the radio spectrum. <a href="http://transition.fcc.gov/Daily_Releases/Daily_Business/2011/db1222/DOC-311652A1.pdf" target="_blank">More details here</a> (download).</p> <p>The innovation will have a great effect on healthcare, as much as scientific advances in medicine. Connectivity has been rated in the top 10 of the best advances in medicine by USA News.</p> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-90504160267439447822011-12-28T21:36:00.000-08:002012-01-21T07:10:40.110-08:00Health Train Express Ends 2011<p> </p> <p>No, Health Train Express is not ending in 2011, rather is signals the time for the annual wrap up on 2011’s big news, small news, and no news.</p> <p>All of this information need not be regurgitated here, but for those of you who automatically check here daily, I than you.</p> <p>I have posted a number of links that will feed your never ending quest for information:</p> <p><a href="http://tinyurl.com/3v85yrq" target="_blank">General News from the U.K.</a></p> <p><a href="http://healthtrain.blogspot.com/2011/11/social-media-answer-to-doctors-lounge.html" target="_blank">Social Media in Medicine: The Answer to the Doctor’s Lounge</a></p> <p><a href="http://tinyurl.com/c4ol4lz" target="_blank">Best Hospitals 2011-2012 The Methodology</a></p> <p><a href="http://tinyurl.com/2d3g7et" target="_blank">Best Hospitals 2011-2012</a></p> <p>Top 10 Medical Breakthroughs: This one is a little more difficult to list. There are a number of determinants, such as basic science, specialization, public health and others which will effect efficiency and cost savings.</p> <p>Listed in reverse order starting with:</p> <p>10. Genetically Modified Mosquitoes to Reduce Disease Threat<br>9. Novel Diabetes Therapy: SGLT2 Inhibitors<br>8. Harnessing Big Data to Improve Heath Care<br>7. Active Bionic Prosthesis: Wearable Robotic Devices<br>6. <em>Implantable Device to Treat Complex Brain Aneurysms</em><br>5. Increasing Discovery with Next-Generation Gene Sequencing<br>4. Medical Apps for Mobile Devices<br>3. Concussion Management System for Athletes<br>2. CT Scans for Early Detection of Lung Cancer<br>1. Catheter-Based Renal Denervation to Control Resistant Hypertension <p>You are free to chose a list from:</p> <p><a href="http://www.time.com/time/specials/packages/article/0,28804,2101344_2100769_2100763,00.html" target="_blank">The Top List of Everything from Times Magazine</a></p> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-53473504492035693072011-12-27T16:04:00.000-08:002012-01-21T07:10:40.206-08:00Social Media in the Health Train<p> </p> <p><img alt="Austin Social Media Marketing" src="http://www.wizmarketings.com/wp-content/uploads/2011/06/Austin-Social-Media-Marketing-1024x558.jpg" width="286" height="166"></p> <p>It seems no matter where you look on the internet the buzz this year has been about social media. Health care is no exception and there are many beating the band how valuable and perhaps essential it will become in the future. </p> <p>Much of it will be dependent upon users preferences for efficiently using limited resources, the most important of which is <strong><u>time</u></strong>.</p> <p><a href="http://lh4.ggpht.com/-wd_UZTTsKgY/Tvpc_c1kcgI/AAAAAAAADJM/zFxCM4YYM7Q/s1600-h/image%25255B3%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh3.ggpht.com/-hXoEul20cfI/Tvpc_-uppKI/AAAAAAAADJU/z7H0uXVvHkM/image_thumb%25255B1%25255D.png?imgmax=800" width="120" height="169"></a></p> <p>For physicians personally time is the most critical limiting factor. The use of social media is financially negligible unless one chooses a social media manager to direct it’s operations. The necessity for this is dependent upon how much resource your organization has to handle this task.</p> <p>The capital investment is close to zero.</p> <p>Physicians can easily acquire the knowledge on how to limit breaches in privacy and confidentiality, and that can be passed on to workers in training. </p> <p>There is some reason to believe that social media adoption may be approaching it’s limits due to time constrictions for employed people. And doctor you fit in to that equation. Your best income producing time is in the clinic seeing patients, or in the surgery doing procedures. </p> <p>Hands on marketing for professionals between professionals is best done hands on face-face, in meetings, making rounds, lecturing for CME, taking an ER patient that is difficult or challenging due to insurance issues. The referring physician will forever be grateful, you will help a patient (even if you have to later refer him to a public facility later) and you may get some patients from the source that is insured or will pay a reduced fee. </p> <p>So in reality you are already in social media….the difference is social media is also on the internet..digital social media.</p> <p>Most users already are aware of many forms of social media, the most common ones being twitter, and Facebook. These two are unique and function differently although the same information can be exchanged in different ways.</p> <p>Twitter has become a means of announcing and reporting medical meetings broadcasting tweets using a hashtag assigned for that particular meeting, as I have previously reported in a previous blog. It may be advisable for those developing annual meetings to assign a # such as AMA11 to designate a 2011 American Medical Association meeting, then changing it to AMA12 for next years meeting. Different Academies may also use their abbreviations as such but should take care to be certain it has not already been pre-empted or users will receive some unwanted tweets.</p> <p><a href="http://tinyurl.com/87abgrh" target="_blank">So who owns your twitter account? That depends, as revealed in recent case law that is pending</a></p> <p>Case in point. Your employee who has been handling your social media leaves and takes with her social media information which may be proprietary in nature or take with him (her) the following they have developed in your social media stream. Who owns the content? That may depend on the nature of the conversation? Was it friend to friend or was it medical, marketing or financial information belonging to the medical practice.</p> <p> </p> <p>Legal counsel may be advisable and also a clear guideline in your employee manual in regard to content using your identification on Twitter, Facebook, Google + or any of the social media platforms</p> <h5>Courts Says Employer's Lawsuit Against Ex-Employee Over Retention and Use of Twitter Account can Proceed<a href="http://tinyurl.com/87abgrh" target="_blank">--PhoneDog v. Kravitz</a></h5> <p><a href="http://tinyurl.com/yb29xh" target="_blank">Jeremiah Owyang ( A Web Strategist) of The Altimeter Group</a> states the golden age of tech blogging may be over.</p> <p><strong>New models to emerge, long form content not the only way</strong></p> <p><a href="http://lh4.ggpht.com/-rUnPqgJyabc/TvpdAHGpCwI/AAAAAAAADJc/Y3ZW8gEZgjw/s1600-h/image%25255B11%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh6.ggpht.com/-RC9LEuKsm7Y/TvpdAoa1CVI/AAAAAAAADJk/fdVcrEz4bNc/image_thumb%25255B4%25255D.png?imgmax=800" width="303" height="225"></a><strong><br></strong>Bloggers themselves know that relying on a single tool isn’t effective, they need a series of tools to use; “blogging isn’t dead. it may have gotten a LOT more social, and it may be less frequent now for those of us who also use <strong>Twitter / Facebook / Tumbler / YouTube</strong> for other distribution efforts, but the overall impact from these platforms together is BIGGER than ever before (and i maintain, also EASIER than ever before if you build it right).”</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:d578035f-6663-4bd3-a28e-23544442870e" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/blogging" rel="tag">blogging</a>,<a href="http://del.icio.us/popular/twitter" rel="tag">twitter</a>,<a href="http://del.icio.us/popular/facebook" rel="tag">facebook</a>,<a href="http://del.icio.us/popular/google+plus" rel="tag">google plus</a>,<a href="http://del.icio.us/popular/social+media+liability" rel="tag">social media liability</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-3947898760530988732011-12-22T20:05:00.000-08:002012-01-21T07:10:40.300-08:00Health Train Express Enters The Village with Sexuality Discussion and Google Plus Hangout<p><img src="http://t0.gstatic.com/images?q=tbn:ANd9GcTfTzAicucPhJinBwFTePiGzqCWP7svXD0B3-yLVbtBZaQiMhkP"></p> <p>“It takes a ‘village” to raise a child” according to Hillary Clinton.</p> <p>Amazing as it seems the latest survey reveals that up to 80% of physicians use one form or another of social media to interact with patients. This despite precautionary warnings about patient privacy and confidentiality.</p> <p>The study did not reveal what form of social media they use; email, instant messaging, twitter, Skype or secured <a href="https://accounts.google.com/ServiceLogin?service=writely&passive=1209600&continue=https://docs.google.com/&followup=https://docs.google.com/&ltmpl=homepage" target="_blank">Google cloud</a> documents. Google Cloud documents can be locked except for the intended readers.</p> <p><img src="http://t1.gstatic.com/images?q=tbn:ANd9GcQCD1VnZtxwHEwkPnGJJAWzGwWYeOM-TqZwhyTZnlzAU80OuEcK-A" width="160" height="111"> <img src="data:image/jpeg;base64,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" width="109" height="109"> <img src="http://t1.gstatic.com/images?q=tbn:ANd9GcQhLulZPzOH8kn6MFHVnUfg5QmGiyQXooKiiZV-GqwNx-Es64ze" width="128" height="109"></p> <p><img src="http://t3.gstatic.com/images?q=tbn:ANd9GcSBxUPZ7bjkDC-2vvT69WqiXGsQbAInho5GxNr4omDDihILHXfSIA" width="241" height="154"> <img src="http://t0.gstatic.com/images?q=tbn:ANd9GcRNtNDlGXYiFvf6SqoRGlerPOH3Vz32-uOLG2NaJpDzRMzVxECM" width="200" height="151"></p> <p>Business uses the cloud for secure transactions and sensitive data, and there will be no shortage of offerings for medical applications. In fact, the cloud may offer a more cost effective and usable platform for a national health information exchange rather than re-inventing the wheel.</p> <p>Now there is a new fast growing platform, Google + and even more revolutionary is Google + Hangouts.</p> <p><u>Google plus Hangout and Sexual Ambiguity</u></p> <p>The following topic was discussed on a public hangout broadcast by a public television station, KOMU TV in Colombia, Mo. Anchorwoman Sarah Hill is a pioneer in the convergent media space. She discusses a personal sensitive issue with Maya Posch born as a hermaphrodite. You will notice the film strip below the large screen of the Hangout participants. The ability to express herself with support from a public audience obviously gives this person hope.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:5737277B-5D6D-4f48-ABFC-DD9C333F4C5D:b6e10ec3-8d65-431c-bb53-726714f87b3f" class="wlWriterEditableSmartContent"><div id="37722da5-64e2-491d-80eb-148828577cd7" style="margin: 0px; padding: 0px; display: inline;"><div><a href="http://www.youtube.com/watch?v=iVsrpXVnOdM" target="_new"><img src="http://lh6.ggpht.com/--hQZsZZSz_E/TvTn4XWojBI/AAAAAAAADI8/KrU2Rg8FH4s/video1e3ebe050299%25255B22%25255D.jpg?imgmax=800" style="border-style: none" galleryimg="no" onload="var downlevelDiv = document.getElementById('37722da5-64e2-491d-80eb-148828577cd7'); downlevelDiv.innerHTML = "<div><object width=\"203\" height=\"114\"><param name=\"movie\" value=\"http://www.youtube.com/v/iVsrpXVnOdM?hl=en&hd=1\"><\/param><embed src=\"http://www.youtube.com/v/iVsrpXVnOdM?hl=en&hd=1\" type=\"application/x-shockwave-flash\" width=\"203\" height=\"114\"><\/embed><\/object><\/div>";" alt=""></a></div></div><div style="width:203px;clear:both;font-size:.8em">Part I Interview with Maya Posch</div></div> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:5737277B-5D6D-4f48-ABFC-DD9C333F4C5D:772b5077-a8b9-4300-8fd1-6336f49b5783" class="wlWriterEditableSmartContent"><div id="af372b77-3cd4-43c7-b9a6-2691a51e3da7" style="margin: 0px; padding: 0px; display: inline;"><div><a href="http://www.youtube.com/watch?v=w1y5cy_YekE" target="_new"><img src="http://lh4.ggpht.com/-r8qHD2foOEA/TvTn4kOZrLI/AAAAAAAADJE/BQp41SDZDbc/videoecfe341148ec%25255B17%25255D.jpg?imgmax=800" style="border-style: none" galleryimg="no" onload="var downlevelDiv = document.getElementById('af372b77-3cd4-43c7-b9a6-2691a51e3da7'); downlevelDiv.innerHTML = "<div><object width=\"207\" height=\"115\"><param name=\"movie\" value=\"http://www.youtube.com/v/w1y5cy_YekE?hl=en&hd=1\"><\/param><embed src=\"http://www.youtube.com/v/w1y5cy_YekE?hl=en&hd=1\" type=\"application/x-shockwave-flash\" width=\"207\" height=\"115\"><\/embed><\/object><\/div>";" alt=""></a></div></div><div style="width:207px;clear:both;font-size:.8em">Part II Interview with Maya Posch</div></div> <p>The scope and power of social media cannot be underestimated among patients who share serious medical issues with like individuals. Caution, the content may be offensive to non-medical viewers. As mentioned in a portion of the video civil rights are part of the challenge in sexual ambiguity. </p> <p>Please pardon the commercial message at the start of the video.</p> <p><a href="http://www.komu.com/player/?video_id=6010&zone=2,5&categories=2,5" target="_blank">KOMU Live Stream Hangout Video</a></p> <p><u>The New Google Health Village</u></p> <p>Health care is now much like a village, or perhaps a group of villages which need to communicate. The convergence of the internet and television, have created a new milieu. Internet or streaming video may replace classical Television much like over the air TV was replaced by satellite or cable.80% of cable television users also hold a hand held device in their hands while viewing news or entertainment programs. They are frequently polled while watching, straw votes are taken during election campaigns.</p> <p>The potential is great for social media for two way interaction with doctor and patient using interactive teaching sessions for patients from your office, or clinic regarding diagnoses, treatment course and for monitoring patient compliance.</p> <p>With the support of Health Train Express Google product developers will develop a new platform, an API dedicated to a Google Medical Application, yet to be named.</p> <p><a href="http://google.com" target="_blank">Google</a>, in it’s infinite wisdom designed the <a href="https://plus.google.com/u/0/photos/117470589447997132376/albums/5654982664399682353" target="_blank">Google+ platform</a> to be secure on a one to one circle share. It is possible to telehealth one to one. Images are of high quality. The medium is extremely cost effective, free for the moment.</p> <p>The project will take several months to complete, and you may read about it here when it is ready for a beta release. Please subscribe to Health Train Express or use an RSS feed to see the announcement.</p> <p>We are looking for suggestions and contributions about what functionality you would like to see in the new Google Medical API. Please tweet me @glevin1 or email me at <a href="mailto:riversideeyemd@gmail.com">riversideeyemd@gmail.com</a></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:1554a851-023a-4f6a-a61d-98ad02fbaf39" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/%23hcsm" rel="tag">#hcsm</a>,<a href="http://del.icio.us/popular/%23healthit" rel="tag">#healthit</a>,<a href="http://del.icio.us/popular/%23healthreform" rel="tag">#healthreform</a>,<a href="http://del.icio.us/popular/hangouts" rel="tag">hangouts</a>,<a href="http://del.icio.us/popular/sexuality" rel="tag">sexuality</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-80069892734416997782011-12-21T08:40:00.000-08:002012-01-21T07:10:40.394-08:00Window’s Notification Alert !! bong!<p> </p> <p><a href="http://www.youtube.com/watch?v=z30oQIEzzvo" target="_blank"><img src="http://t3.gstatic.com/images?q=tbn:ANd9GcSZlHT2NgET-MwkpgMDibNKImT5wBMFsYaKvKUY3hM2j7Wo5awBiQ" width="131" height="103"></a></p> <p>Today’s <a href="http://www.youtube.com/watch?v=z30oQIEzzvo" target="_blank">wake-up alert</a> from <u>The Washington Post</u></p> <p><i>“The Obama administration Monday named <a href="http://innovations.cms.gov/initiatives/aco/pioneer/">32 health care systems</a> across the country as “Pioneer” ACOs. These will be the first places to test out the new payment model; they’ll provide a bit of a sneak peak at what it could mean for the rest of the country. In other words, we may soon see our first <a href="http://en.wikipedia.org/wiki/Unicorn" target="_blank">unicorns.</a></i></p> <p><a href="http://lh4.ggpht.com/-ipnqyrxsXu0/TvIL7OqZuKI/AAAAAAAADIk/ZetIBIXxxh8/s1600-h/image%25255B2%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh6.ggpht.com/-bRLNlpt85oE/TvIL7UaylLI/AAAAAAAADIs/3RdsnH4bHCs/image_thumb.png?imgmax=800" width="224" height="184"></a></p> <p>Unicorn, or not it is interesting that they chose 30 health systems which are already business entities and well <a href="http://www.phs.org/PHS/about/" target="_blank">integrated health systems</a>. They are also located in unique health care markets.</p> <p>Jim Hinton, President and CEO of Presbyterian Health System (one of the lucky 30 chosen makes these remarks in the Washington Post article authored by Sarah Klif. </p> <p>“<b>Jim Hinton:</b> Health care has grown up in a fee-for-service system, and it’s also grown up with a system where the primary unit is an individual doctor taking care of an individual patient. At Presbyterian, we’ve been working on making care more integrated for 20 or so years now and have been able to do a lot by operating our own health plan..</p> <p><b></b>A lot of what [the Accountable Care Organization model] does is build a system of care where there’s a safety net and we can help advocate for the patient. We’re looking at how can we do more with nurses and other advance practice professionals. How can we use technology? How can we change the visit model so its not one patient with one doctor every 15 minutes? <p>He offers some creative solutions for extending benefits such as home health care by up regulating it to a ‘home hospital’, reducing the cost of in patient hospitalization, but increasing the amount of home health care. To me this just seems to be cost shifting and would require major re-designs of accounting for the ACO. <p>All of these proposals are well hidden in the PPACA and the net effect is going to take a decade or more to be studied. <p>We’re experimenting with some group visits with doctors, and also another program where we hospitalize people in their homes. One good metaphor is thinking about it as if you were going to remodel your house. If you had a plumber, carpet-layer and someone putting down tiles not talking to each other, the house might not turn out very well. The idea is to anchor all the care in one place, where there’s a lot of coordination. <p>Mr Hinton summarizes it well for the rest of medicine. <p>“<b>“SK: As you mentioned earlier, your health system has been working on moving toward more integrated care for over 25 years now. What about the health care providers that haven’t been working on this stuff? How well do you think they’ll be able to use these new incentives?</b> <p><b>JH: </b>My colleagues who come from systems that have not owned managed care organizations are trying to assess how they can accelerate into this mindset. Most hospital systems today have some experience employing physicians but I think there are still two big barriers in going towards more integrated care. One is bringing an insurance perspective to populations, where you’re managing care and managing risk. The second is a cultural one. Many health care providers have fee-for-service as one of their core business models. It’s hard to get away from this notion that doing more health care means earning more money” <p>I do not see ACOs catching fire in much of medicine. In fact I predict that smaller towns will continue on their current merry way. Some ACOs may very well have to contract out some professional services depending on the willingness of the physician community to forfeit freedom and independence. This will invoked the laws of secondary consequences with it’s attendant unforeseen challenges. <p>Physicians resistant to ACOs may very well boycott a local ACO if given that alternative. <p>Nothing for sure is certain.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:8eef972c-5c5c-449d-a6aa-1ffcfe771b25" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/aco" rel="tag">aco</a>,<a href="http://del.icio.us/popular/accountable+care+organization" rel="tag">accountable care organization</a>,<a href="http://del.icio.us/popular/incentives" rel="tag">incentives</a>,<a href="http://del.icio.us/popular/outcomes" rel="tag">outcomes</a>,<a href="http://del.icio.us/popular/hhs" rel="tag">hhs</a>,<a href="http://del.icio.us/popular/medicare+reform" rel="tag">medicare reform</a>,<a href="http://del.icio.us/popular/ppaca" rel="tag">ppaca</a>,<a href="http://del.icio.us/popular/integrated+health+systems" rel="tag">integrated health systems</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-20198285896272968302011-12-19T17:19:00.000-08:002012-01-21T07:10:40.486-08:00The Issue in Health Care is NOT Money<p> </p> <p><img src="data:image/jpg;base64,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" width="201" height="256"></p> <p>Contrary to what poor or affluent people think, money does not solve all problems of health care, and it will never stop the issues of caring for one another in a health system.</p> <p><img src="http://t2.gstatic.com/images?q=tbn:ANd9GcTzaDg2JY8nKINPsjCC7oF5y8x5Xdzk1zBfj4sYenIa39CCWhLn"></p> <p>I believe the entire national budget could be thrown at health care and there would still be a problem of ‘not enough money’. There is more than enough funding to maintain good health, wellness and treat those who are no longer healthy and/or well.</p> <p><img src="http://t1.gstatic.com/images?q=tbn:ANd9GcRDdJwslEsRt4W4tNIMftqZzOgA8Xzy4Rn8aQX3pg1ZLscEUeefkBD75bNv5Q"></p> <p>Precious resources are expended on studies, fighting fraud and abuse, having analysts draw graphs that either intersect dangerously at some time in the future, or have in the past. My favorite one is the exponential graph rising vertically into infinity.</p> <p>The issues are much like the impasse about the debt ceiling. Political expediency and prostituting opinions for votes. We ask politicians to make decisions from false economics, and figures that may be highly inaccurate, against a setting of voting on issues they know nothing about except how it affects a state or federal government.</p> <p>Case in point is the current conflict about mandated insurance coverage.</p> <p>Much has been said about using the current medi-caid system to fill in the blanks. This is a more than stupid idea for many reasons. </p> <p>1 The current system is not designed nor can it accommodate more patients. </p> <p>2. The current system in many states do not have enough providers to service the huge increase in patients.</p> <p>3.. The current system is not designed to care for patients. It is cumbersome and designed to deny care for any possible reason, financial, missing paperwork, or a vacant modifier in the billing codes.</p> <p>4. The current system does not respond to market indicators, and reimbursement methodology is byzantine. </p> <p><img src="http://t3.gstatic.com/images?q=tbn:ANd9GcTlWvIXeqLkaQNK83a6lLIP5D49JFdCa2QOKyuIEc8b6vChYv-P"></p> <p>5. The current system needs to be “occupied”</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:a24e18da-5d58-43e4-8d03-0f503d401a64" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/reimbursement" rel="tag">reimbursement</a>,<a href="http://del.icio.us/popular/money" rel="tag">money</a>,<a href="http://del.icio.us/popular/occupy" rel="tag">occupy</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-71717985080170670822011-12-17T11:54:00.000-08:002012-01-21T07:10:40.580-08:00Ticket Price Increases on the Health Train Express in a Time Calling for Austerity<p> </p> <p>Like the airlines, who are not too big to fail, medical practices will need to find ways to increase revenues. It’s too bad our patients don’t carry baggage into our offices so that we could have a surcharge modifier such as –0000 for each item.</p> <p>However physicians can emit a sigh of relief with the announcement from on high at HHS, as brought to us by the American Medical Association, in <a href="http://tinyurl.com/d9pjcw2" target="_blank">AMED News</a>. Included in that news are:</p> <p>Physicians meeting criteria in 2011 to earn federal electronic medical record incentives will have more time before the Dept. of Health and Human Services requires them to satisfy tougher standards for attaining additional bonuses. The move is being viewed by physicians and health policy observers as a goodwill gesture by the Obama administration toward EMR early adopters. <u>( Who cares what Obama thinks about goodwill? The AMA ?)</u></p> <p>True to form modifications are being made to the calendar for implementation-incentive reward-penalty dates because the initial proclamations and mandates were poorly planned. What we have in the federal government is a group of “cheerleaders’ encouraging the workers how much health IT will improve patient care. Even the AMA buys into that.</p> <p>No Doctor Left Behind ? This sounds much like the Bush Plan of No child left behind.</p> <p>Public health studies have shown that more doctors want to participate in the EMR adoption program. A study from the Centers for Disease Control and Prevention found 52% of office-based physicians plan to register and attest to meeting program requirements for 2011, which is an increase from the 41% who planned in 2010 to do so. The total portion of physicians who have adopted EMRs also is at 34% in 2011, up from 17% in 2008. </p> <p>It takes a lawyer to make the following statement,</p> <p>“</p> <p>“There are several takeaways for physicians from Sibelius' announcement,” said Stephen Bernstein, an attorney who is the international head of the health industry practice group at McDermott Will & Emery in Boston. In general, more physicians are adopting EMRs and using the technology to improve their practices. <p>“HHS also is sending a message to physicians who are undecided about whether they should make a significant investment in electronic recordkeeping”, Bernstein said. “The agency will work with physicians to help them adopt EMRs”. He suggested that doctors get in touch with one of 62 federal regional extension centers that have been established to help physicians, in particular small primary care practices, adopt EMRs. <p>"The main message is that there are federal government programs out there to help physicians, and the federal government isn't going to stop offering help," he said. <p><strong>“It’s okay, we are here from the government to help you.” </strong>(author) <p>Bernstein added that a robust EMR system is needed to participate in new Medicare payment models, such as accountable care organizations. If CMS wants physicians to participate in these initiatives as well, it must do everything it can to encourage doctors to use EMRs, he said. <p>It’s a bundled plan, just like reimbursements. Step C is dependent on steps A and B. (If they work in the first place) <p><u>Clearly it is disruption disrupting disruption. Even chaos theory fails to keep up with these advances in advanced health care physics.</u> <p><a href="http://lh5.ggpht.com/-a3fl1REMmFE/TuzzYTlXVmI/AAAAAAAADIQ/KKhZAi_h2UE/s1600-h/image%25255B3%25255D.png"><img style="background-image: none; border-bottom: 0px; border-left: 0px; padding-left: 0px; padding-right: 0px; display: inline; border-top: 0px; border-right: 0px; padding-top: 0px" title="image" border="0" alt="image" src="http://lh4.ggpht.com/-BxBSS0gq6zY/TuzzY2gUtuI/AAAAAAAADIY/dagKCJ5TZng/image_thumb%25255B1%25255D.png?imgmax=800" width="201" height="149"></a> <p>The incentive program is clearly aimed at primary care MDs, and the recent statistics reveal it. <p><strong><u>Specialty </u> <u> # Participating in Bonus</u></strong> <p>Family practice 1,216 <p>Internal medicine 1,198 <p>Cardiology 517 <p>Podiatry 378 <p>Gastroenterology 232 <p>Orthopedic surgery 201 <p>General surgery 197 <p>Urology 197 <p>Nephrology 174 <p>Neurology 148 <p>Other 1,347 <p><strong>What Medicaid Paid for EMR Bonuses</strong> <p>Physician 6,609 $138.5 million <p>Nurse practitioner 1,463 $31.1 million <p>Acute care hospital 607 $483.9 million <p>Dentist 333 $7.1 million <p>Certified nurse midwife 172 $3.7 million <p>Physician assistant 107 $2.3 million <p>Children's hospital 15 $45.1 million</p> <p>What is even more worrisome is the profound recession we are experiencing, the HHS emphasizes the ARRA and Hitech have produced 50,000 job…a mere drop in the bucket. Our budget deficit is crippling planning at the federal and state level….</p> <p>More than incentives we need austerity.</p> <p>Stay tuned for more modifications<br></p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:1329ac57-6fcb-4b85-936f-900e2e0bf8b3" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/medicare+reform" rel="tag">medicare reform</a>,<a href="http://del.icio.us/popular/incentives" rel="tag">incentives</a>,<a href="http://del.icio.us/popular/primary+care" rel="tag">primary care</a>,<a href="http://del.icio.us/popular/hitech" rel="tag">hitech</a>,<a href="http://del.icio.us/popular/arra" rel="tag">arra</a>,<a href="http://del.icio.us/popular/papca" rel="tag">papca</a>,<a href="http://del.icio.us/popular/sibelius" rel="tag">sibelius</a>,<a href="http://del.icio.us/popular/hhs" rel="tag">hhs</a>,<a href="http://del.icio.us/popular/obamacare" rel="tag">obamacare</a>,<a href="http://del.icio.us/popular/ama" rel="tag">ama</a>,<a href="http://del.icio.us/popular/amednews" rel="tag">amednews</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-12027254570051463332011-12-14T21:08:00.000-08:002012-01-21T07:10:40.674-08:00Touchfire with Health Train Express<p> </p> <p>Another bold innovation (and why didn’t I think of this before?) The beauty of this is that it offers another functionality to the iPad form factor. without the burden of extra parts. Although the iPad offers a keypad feature, users complain there is no tactile feedback which touch typists use unconsciously to type. And the addition of an external keyboard adds to more clutter.</p> <p>This flexible plastiform rubberized overlay is held in place by magnets which attack to the border of the iPad’s frontface. It gives the user tactile feedback much like a normal keyboard. It also has other features attaching it to iPads official cover.</p> <p><iframe style="width: 370px; height: 281px" height="315" src="http://www.youtube.com/embed/Gr4Wqbd-7qM?rel=0" frameborder="0" width="420" allowfullscreen></iframe></p> <p>All in all a dandy device for the clinic, by the bedside or in the hospital.</p> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-73473912594748851232011-12-13T20:23:00.000-08:002012-01-21T07:10:40.762-08:00Health 2.0 in Social Media<p> </p> <p>Monitoring the social media stream today in #hcsm #medicine #healthreform and find that Facebook will offer a page and/or referral to FBers who are depressed and suicidal. Is this the first step into Health 2.0 and is social media going to bypass formal developments in the Health 2.0 Challenge?</p> <p>Mobile apps already support API for all the social media platforms, twitter, facebook, and Google +. Twitter is very restrictive as to which APIs can use twitter’s API however health 2.0 would gain them many more users that do not compete with Twitter’s plans.</p> <p><img src="http://webdesignledger.com/wp-content/uploads/2009/04/social_media_icons_20.jpg" width="205" height="158"><img src="https://encrypted-tbn3.google.com/images?q=tbn:ANd9GcTX3BjR9LJW5T25kYB3GMk6kO4rxE2ub1axH8yzjtIqYkKX69zH" width="208" height="162"></p> <p>I predict that Social media will bypass the present vision for formal health 2.0 apps, and developers should re-think their game plans or be left behind even before it happens.</p> <p>G+ offers the potential for telehealth with video and it should not be hard for programmers to build a secure encrypted API to comply with HIPAA. It is accessible on smartphones, iPads and many tablet PCs. </p> <p>I held a G+ hangout on Tuesday night at 6PM. The attendance was zero. A big disappointment but not a surprise at all. Not many MDs and few #hcsm users are on Google + Experience reveals it takes about one month for the stream to capture interested social media participants.</p> <p>Google + has a predominance of artists, performers, and photographers. Even if you don’t want to hangout in health care…it is a broadening experience and revealing as to how much talent there is besides American Idol and the network cable offerings.</p> <p>Health Train is the most prominent MD and health related +er on Google.</p> <p>You can find Health Train’s profile on Google + at the <a href="https://plus.google.com/u/0/114503806689722509896/posts" target="_blank">Google ID</a>. Join and put me in one of your circles. Hope to see you all there.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:ae2f2dc8-ea75-4148-ad14-81e1212b4dc6" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/social+media" rel="tag">social media</a>,<a href="http://del.icio.us/popular/%23hcsm" rel="tag">#hcsm</a>,<a href="http://del.icio.us/popular/%23medicine+2.0+conference" rel="tag">#medicine 2.0 conference</a>,<a href="http://del.icio.us/popular/Google+%2b" rel="tag">Google +</a>,<a href="http://del.icio.us/popular/twitter+%2b" rel="tag">twitter +</a>,<a href="http://del.icio.us/popular/Facebook" rel="tag">Facebook</a>,<a href="http://del.icio.us/popular/Google%2bhangouts" rel="tag">Google+hangouts</a>,<a href="http://del.icio.us/popular/telehealth" rel="tag">telehealth</a>,<a href="http://del.icio.us/popular/health+2.0" rel="tag">health 2.0</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.comtag:blogger.com,1999:blog-5873912379101892616.post-81720097122607286542011-12-12T12:22:00.000-08:002012-01-21T07:10:40.858-08:00And The Webcina Winners are:<p> </p> <p><img src="http://scienceroll.files.wordpress.com/2011/12/wingrandprizes.jpg?w=460"></p> <p><a href="http://www.webicina.com/?select=null" target="_blank">Webcina</a> announced it’s winners for their contest for social media participants. Although Healthtrain Express failed to make it to the podium I enjoyed participating and ‘spilling my beans”. My reward was to be able to read these fine stories..Stories that should excite all of us in social media.</p> <p>I read the winning blog posts, and found them all to be far better in appeal and content than my illiterate meanderings.</p> <p>Here they are:</p> <p><a href="http://tinyurl.com/7dsjeo7" target="_blank">The Tap Code by Katherine Leon</a></p> <p><a href="http://www.youtube.com/watch?v=lEp06x-YuV8" target="_blank">Transient Global Amnesia and Social Media by Susan McKinnon</a></p> <p><a href="http://sarahezekiel.blogspot.com/2011/11/social-media-me.html" target="_blank">Suzanne Ezekiel’s Journey</a> Her contribution includes her vivid youtube video portraying the effects of her disease. It is one of the most telling and vivid descriptions that leaves the observer breathless and battered. It probably should receive some type of award in videography and story content.</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:5737277B-5D6D-4f48-ABFC-DD9C333F4C5D:43feee6e-ae15-4505-9c19-a3a74c10ee5e" class="wlWriterEditableSmartContent"><div id="a27c5329-6115-4cdc-8631-9f9e8d03deba" style="margin: 0px; padding: 0px; display: inline;"><div><a href="http://www.youtube.com/watch?v=tz6F955tAIk" target="_new"><img src="http://lh6.ggpht.com/-XcwzTR-p8Yc/TuZibdiqcAI/AAAAAAAADH8/nRqd0u4IHFI/video1af4e488bce1%25255B19%25255D.jpg?imgmax=800" style="border-style: none" galleryimg="no" onload="var downlevelDiv = document.getElementById('a27c5329-6115-4cdc-8631-9f9e8d03deba'); downlevelDiv.innerHTML = "<div><object width=\"448\" height=\"252\"><param name=\"movie\" value=\"http://www.youtube.com/v/tz6F955tAIk?hl=en&hd=1\"><\/param><embed src=\"http://www.youtube.com/v/tz6F955tAIk?hl=en&hd=1\" type=\"application/x-shockwave-flash\" width=\"448\" height=\"252\"><\/embed><\/object><\/div>";" alt=""></a></div></div><div style="width:448px;clear:both;font-size:.8em">Take My Body Away</div></div> <p>Thank you Webcina !!</p> <div style="padding-bottom: 0px; margin: 0px; padding-left: 0px; padding-right: 0px; display: inline; float: none; padding-top: 0px" id="scid:0767317B-992E-4b12-91E0-4F059A8CECA8:6e639474-74fc-4c1c-ac9a-94ac61b5ce90" class="wlWriterEditableSmartContent">del.icio.us Tags: <a href="http://del.icio.us/popular/webcina" rel="tag">webcina</a>,<a href="http://del.icio.us/popular/motor+neuron+disease" rel="tag">motor neuron disease</a></div> crutcrithttp://www.blogger.com/profile/09269806261919869067noreply@blogger.com