November 24, 2006

It was a very good year (in-review)

Filed under: — mlazoff

American Medical Informatics Association (AMIA) 2006 Year in Review groups selected articles on medical computing that were published this year in major medical journals by topic, with links to PubMed abstacts. This wonderful resource was created by Daniel Masys, MD chairman of Vanderbuilt University Medical Center Department of Biomedical Informatics and was taken from Dr. Masys’s presentation at a recent AMIA Symposium; his slides can be accessed online as well.

September 4, 2006

The Times They Are A-Changin’…A Little, Take 2

Filed under: — mlazoff

EMR graphElectronic Medical Record Use by Office-Based Physicians: United States, 2005 is an annual survey conducted by CDC National Center for Health Statistics of 1,281 office-based physicians sampled from the American Medical Association and American Osteopathic Association databases. (Enlarge graph)

According to last month’s press release, key findings include:

  • Nearly 1 in 4 (23.9 percent) physicians reported using full or partial electronic medical records (EMRs) in their office-based practice in 2005 — a 31 percent increase from the 18.2 percent reported in 2001. 
  • Physicians in the Midwest (26.9 percent) and West (33.4 percent) were more likely to use EMRs than those in the Northeast (14.4 percent).
  • Physicians in metropolitan statistical areas (nearly 24.8 percent) were more likely to use EMRs than were those in non-metropolitan areas (16.9).
  • Only 1 in 10 (9.3 percent) physicians, however, used EMRs with all four of the basic functions (computerized orders for prescriptions, computerized orders for tests, reporting of test results, and physician notes) considered necessary for a complete EMR system.

These results are consistent with those presented in an earlier N&V item, The Times They Are A-Changin…A Little, which described a June 2006 report by The Center for Studying Health System Change, though this survey included physicians working in both hospital-based as well as office-based practices, and those with access to (not necessarily use of) electronic records. 

August 29, 2006

Diagnostic FreeCell

Filed under: — mlazoff

According to a Medical News Today article first published last month, OHSU Scientists Say FreeCell Can Be Adapted To Spot Early Signs of Dementia. As many PC users are aware, FreeCell was one of the first solitare games freely bundled to Windows operating systems. “‘It requires significant planning to play well, and planning is one measure that neuropsychologists attempt to test in clinical situations,’” [OHSU Oregon Center for Aging & Technology investigator Holly] Jimison [PhD] said. ‘We’re trying to replicate that, and we’ve been able to show that we can, at least in early studies with small numbers of people, show distinctions between cognitively healthy elders and those with even mild cognitive impairment.’” Jimison and study co-author Misha Pavel, PhD, professor of biomedical engineering and computer science and electrical engineering at OHSU’s OGI School of Science & Engineering, studied nine people with an average age of 80. All were regular computer users who played the FreeCell game frequently over a six-month period. Each participant was given a cognition score based on a brief battery of tests, and three were found to have mild cognitive impairment.” The article noted that several researchers, including Drs. Jimison and Ravel, also are employees of Spry Learning, a company that may have a commercial interest in the results of this research, though the conflict was reviewed and approved by the OHSU Conflict of Interest in Research Committee. According to their Web site, “Spry Learning is part the Executive Board of a consortium of organizations (including OHSU, Intel, HP and GE) to win an NIA Roybal Center grant for applied research to keep older persons independent, active, and productive in later life.”

July 15, 2006

I, Neuroprostheses

Filed under: — mlazoff

The Web focus of the July 13th issue of Nature is on neuroprostheses: electronic brain implants that translate the intention to move into actual movement of (currently) a robotic device, computer cursor, or (ultimately) paralyzed limbs. This is a wonderful all-on-one-page multimedia potpourri of link resources that include free full text access to this issue’s two published studies: one out of Brown University, on Neuronal ensemble control of prosthetic devices by a human with tetraplegia; and a second out of Stanford University, on A high-performance brain-computer interface involving rhesus monkeys. The video streaming and experimental footage is fun viewing of this technology at its infancy. Alas, the news features and Archives of past Nature articles on the topic are not freely available to non-subscribers. A sobering editorial closes with a reference to the Six Million Dollar Man of 1970s television: “The idea of giving people superhuman powers greatly appeals to the popular imagination. But in the real world, using neuroprosthetics to give patients control over all the less glamorous things we take for granted will be more important.”

July 4, 2006

The Times They Are A-Changin’…A Little

A June 2006 report by The Center for Studying Health System Change, Growing Availability of Clinical Information Technology (IT) in Physician Practice, compared its 2004-05 data with that collected in a similar manner four years earlier. The 2004-05 telephone survey involved 6,600 full time office- and hospital-based physicians identified through AMA and AOA master files, on the availability of computers in their practice for five clinical activites: accessing guidelines and treatment alternatives; sharing patient data electronically with other physicians; electronic medical records; automated reminders and prompting systems; and e-prescribing. 

Based on these results, the availability of computers in patient care is catching on. From the report: “The proportion of physicians reporting their practice has IT access for four or five of the clinical activities nearly doubled over the period, growing from 11.1 percent to 20.9 percent. And significantly fewer physicians reported being in practices with limited clinical IT, with the percentage of physicians in practices with IT for no more than one clinical activity dropping from 50.6 percent to 37.0 percent.” The report notes, however, that ”…despite substantial growth rates for clinical IT across the five clinical activities—between 23 percent and 97 percent over the four-year period—many physicians still lack access to practice-based clinical information technology. For example…nearly 80 percent of physicians lacked IT to write prescriptions in 2004-05. And more than a third of physicians didn’t have IT for the easiest-to-implement activity—accessing guidelines and treatment alternatives.” 

Note that the physicians were not asked if they use computers in their practice, only the first step in that process: whether computers with these specific programs are available. If we assume the majority of physicians are satisfied using what’s available to them in their practice–alas, a very big assumption–then, according to the S curve of technology adoption, some of these practice-base clinical computer programs that were leading edge four years ago are now approaching state of the art. The Center for Studying Health System Change is a nonpartisan policy research organization located in Washington, D.C. 

July 3, 2006

Welcome to News&Views

These concise (ideally) summaries and occasional irreverencies on medical computing and assorted topics will be written by Marjorie Lazoff, MD with Lee Ann Riesenberg, PhD, RN, riding shotgun as editor. Kudos to Rhizoid Design for adapting the News&Views interface to meet our picky needs. Drs. Lazoff and Riesenberg both work on the open-access publication Medical Computing Review, freely available elsewhere on this site, which we hope you will visit and enjoy. 

Happy Independence Day! 

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