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Electronic Prescription

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4601. Why blockchain technology might replace today’s EHRs

about today’s EHRs, alongside a variety of ways to address the problems they create. One solution may lie in blockchain, the technology currently powering the cryptocurrency Bitcoin. First, what’s to love about EHRs? Information is power. Electronic health records give doctors (somewhat) fast, reliable and secure access to patient medical histories, prescription records and past test results. With this data, several integrated, multi-specialty medical groups like Mayo Clinic, Intermountain (...) Why blockchain technology might replace today’s EHRs Why blockchain technology might replace today's EHRs Why blockchain technology might replace today’s EHRs | | April 24, 2018 19 Shares Physicians have a love-hate relationship with the electronic health record (EHR). On the one hand, doctors know they can’t provide the best possible medical care without them. And on the other, today’s EHR systems are cumbersome, clunky and slow physicians down. Indeed, there’s much to love and much to hate

2018 KevinMD blog

4602. It’s time for a shake up: Driving system wide change to improve musculoskeletal pain care and outcomes

, and the collation and monitoring of system, clinical and patient-reported outcomes are critical if we are to address the escalating burden associated with musculoskeletal pain conditions. Here are two examples: The electronic Persistent Pain Outcomes initiative ( )[5] is an implementation initiative of the Australian and New Zealand College of Anaesthetists, Faculty of Pain Medicine. ePPOC enables a systemised electronic collection of a standardised set of data items and assessment tools by specialist pain (...) , Hayes C, Eagar K. Establishment of the Australasian Electronic Persistent Pain Outcomes Collaboration. Pain medicine 2016. Stanford University. The Collaborative Health Outcomes Information Registry. 2017. (accessed February 27th 2017). Slater H, Briggs AM. . Pain Manag 2017; 7 (5): 351-7. UC Davis. Advancing Pain Relief Education: Anchoring Pain Competencies Around the World. 2016. ) (accessed February 27th 2017). Slater H, Dear BF, Merolli MA, Li LC, Briggs AM. . Best practice & research Clinical

2018 Body in Mind blog

4603. The intensity of EMR warnings: Who do they really help?

, when I prescribe a medication using our office’s beloved electronic medical record (EMR), a red warning flashes indicating that there is a potentially severe interaction with one of the patient’s current medications. The intensity of the warning would suggest that I was prescribing cyanide or rat poison. Our EMR allows me to bypass the warning and prescribe anyway, leaving this action memorialized in the EMR and available to plaintiff attorneys who might be in a position to query me (...) on this decision, should an adverse medical event ensue. Now, I take these warnings seriously and would never place a patient at risk, unless the medical circumstances justified it, and the patient was properly informed. My point is that many of these electronic warnings are hyperbolic, if not spurious. Many times when I call a pharmacist — a human drug professional — in the presence of the patient, I am advised that there is no material risk. In fact, the last time I did this just a few weeks ago

2018 KevinMD blog

4604. Gwyneth Paltrow shows that the Quantum Xrroid Consciousness Interface was ahead of its time, as NASA slaps down Goop

to experience a complete mind-body reset. Bafflegab. Personally, I will give Goop credit for about this product that is undoubtedly true: P.S. Leaving them on for the prescribed three-day period left a few goop staffers with marks on their skin, so be careful to stick them somewhere concealable if you’ve got an event coming up. Good to know. They are, after all, stickers, and you wouldn't want nasty marks from the adhesive show near your cleavage or bare shoulder while wowing everyone at the latest party (...) (by coincidence). The electromagnetic dawn chorus is believed to be generated by a Doppler-shifted cyclotron interaction between anisotropic distributions of energetic (> 40 keV) electrons and ambient background VLF noise. These energetic electrons are generally injected into the inner magnetosphere at the onset of the substorm expansion phase. Dawn choruses occur more frequently during magnetic storms. to post comments By Tim (not verified) on 26 Jun 2017 to post comments By MaineJen (not verified) on 26 Jun

2017 Respectful Insolence

4605. Whole Genome Sequencing for All? The Quest for Evidence Continues

on his father’s history of early onset heart disease, John underwent a battery of genetic tests. He was found to be at increased risk of coronary artery disease, colon cancer, and lung cancer. The following is a personalized hypothetical medical intervention based on : “By 2010, the field of pharmacogenomics has blossomed, and a prophylactic drug regimen based on the knowledge of John’s personal genetic data can be precisely prescribed to reduce his cholesterol level and the risk of coronary artery (...) include its randomized design, use of validated instruments, and use of electronic health records data to assess medical care. Larger trials and more diversity in patient populations will be needed to determine the effect of WGS as a screening tool on the health of populations. Interestingly, a decade ago, our office conducted a much larger randomized clinical trial to evaluate the health benefits of systematic collection and use of compared to standard of care and found some health benefits for using

2017 CDC Genomics and Health Impact Blog

4606. Tell the FDA not to embrace quackery: Write to oppose its proposal on acupuncture and chiropractic for chronic pain

will all have a chance to weigh in. The FDA will take . The blueprint released this week is part of a strategy the FDA rolled out in 2011 to address a crisis of prescription drug abuse. The FDA required opioid manufacturers to provide education for health providers who prescribe their pain medications — but didn’t mention chiropractic care or acupuncture in for what that education ought to look like. Interesting. I wonder how that one line recommending acupuncture and chiropractic found its way (...) . The guidelines now recommend that doctors get information about chiropractic care and acupuncture as therapies that might help patients avoid prescription opioids. “[Health care providers] should be knowledgeable about the range of available therapies, when they may be helpful, and when they should be used as part of a multidisciplinary approach to pain management,” the agency wrote in the proposal. The suggested changes come as chiropractors and other alternative medicine providers have stepped up lobbying

2017 Respectful Insolence

4607. Choosing Wisely around the world: Professionalism as a force to reduce unnecessary care

healthcare systems, insurers, government, and payers can chip away at professionalism, and pull physicians’ primary focus away from patients. , physicians spent just a quarter of their time in direct face to face contact with patients, while about half of their time was spent on electronic health record (EHR) and desk work. It should not come as a surprise then that in this environment of limited time and limited physician-patient interactions, overtesting and overinvestigation persists. Indeed, when (...) with patients. In fact, more mature campaigns are seeing progress on identified shortcomings. In Canada, for example, there is of evidence of of Choosing Wisely recommendations, which has been led by clinicians. Canada’s next steps include strategies to scale up local implementation and to measure outcomes. Collaboration with the Organization for Economic Cooperation and Development (OECD) has led to the introduction of three indicators of overuse (the overall number of antibiotic prescriptions

2017 The BMJ Blog

4608. Jane Morris: Do school children need happiness lessons?

drinks and takeaways rather than sitting down to eat together at school or home. We abandon them to the mean streets of social media without proper security systems because we’re not virtually streetwise ourselves. Secondary schools are getting bigger and becoming increasingly focused on academic results. For many adolescents, “play” and leisure time means all-nighters round electronic game consoles. Only felt that they got enough sleep, exercise, rest, and time for reflection. Psychological self (...) attempt to soothe the students’ extreme exam stress, which might interfere with their place in the league tables. Not all patients are the same. This raises the question of whether it’s better to offer these lessons and techniques to targeted groups or to all young people. We don’t yet know what sort of intervention we are dealing with here. Is mindfulness psychological fluoride—something to be added to the tap water? Or is it the mental health equivalent of prescribing antibiotics to all children

2017 The BMJ Blog

4609. Richard Lehman’s journal review—13 March 2017

This is . It is a sort of Proust biscuit, bringing back memories of warm, wood floored libraries with the whirr of a photocopier in a distant corner. No electronic screens then, except perhaps a flickering greenish thing in the keep of the librarian. Here is pure exam knowledge for the world outside the northeastern and upper midwestern regions of the United States, where the incidence of babesiosis has increased dramatically in the past 10 years. This is “a tickborne zoonotic disease caused by intraerythrocytic (...) data and clinical experience will be useful to determine how polypills can best be implemented to achieve this goal.” The Lancet has chosen the positive speculation in this passage for its front cover and left out the rest. The , which is not really a science but a bunch of strategies that you bring to bear once you have proved something works. Unless you intend to put the polypill into the water supply, this consists of persuading individuals to take a pill every day for life. For the prescriber

2017 The BMJ Blog

4610. Childhood Acute Myeloid Leukemia/Other Myeloid Malignancies Treatment (PDQ®): Health Professional Version

Health Organization (WHO) system described below, categorized AML into major subtypes primarily on the basis of morphology and immunohistochemical detection of lineage markers. The major subtypes of AML include the following: M0: Acute myeloblastic leukemia without differentiation.[ , ] M0 AML, also referred to as minimally differentiated AML, does not express myeloperoxidase (MPO) at the light microscopy level but may show characteristic granules by electron microscopy. M0 AML can be defined

2015 PDQ - NCI's Comprehensive Cancer Database

4612. Merkel Cell Carcinoma Treatment (PDQ®): Health Professional Version

.: Treatment of merkel cell carcinoma. Am J Clin Oncol 27 (5): 510-5, 2004. [ ] Cellular Classification of Merkel Cell Carcinoma Although the exact origin and function of the Merkel cell remains under investigation, it is thought to have features of both epithelial and neuroendocrine origin and arise in cells with touch-sensitivity function (mechanoreceptors).[ - ] Characteristic histopathologic features include dense core cytoplasmic neurosecretory granules on electron microscopy and cytokeratin-20 (...) , evaluated with uniform clinical staging procedures, treated with uniform treatment protocols, or provided with regular, prescribed follow-up. These reports are also confounded by potential selection bias, referral bias, and short follow-up; and they are underpowered to detect modest differences in outcome. In addition, outcomes of patients with American Joint Committee on Cancer stage I and stage II disease are often reported together. In the absence of results from clinical trials with prescribed work

2015 PDQ - NCI's Comprehensive Cancer Database

4613. Adult Soft Tissue Sarcoma Treatment (PDQ®): Health Professional Version

? A retrospective analysis of 174 patients. Br J Cancer 110 (10): 2420-6, 2014. [ ] [ ] Krieg AH, Hefti F, Speth BM, et al.: Synovial sarcomas usually metastasize after >5 years: a multicenter retrospective analysis with minimum follow-up of 10 years for survivors. Ann Oncol 22 (2): 458-67, 2011. [ ] Cellular Classification of Adult Soft Tissue Sarcoma Soft tissue sarcomas are classified histologically according to the presumed tissue of origin. Electron microscopy, specialized immunohistochemistry, flow (...) the full prescription dose and to maintain local control while potentially reducing radiation therapy–related morbidity. Initial single-institution reports suggest that high rates of local control with some reduction in morbidity are possible with this technique.[ , ] Retrospective comparison of IMRT and 3-dimensional, conformal radiation therapy demonstrates that local recurrence for primary soft tissue sarcomas of the extremity was worse in the non-IMRT group.[ ][ ] Surgery and radiation therapy

2015 PDQ - NCI's Comprehensive Cancer Database

4615. A conversation with a Rigvir flack

don’t care about existing registration, but unfortunately your analysis is used to doubt the registration. Which is off course strange, because nowhere in the world rules and regulations (in our case standards for clinical trials) are used with backward date. Yes for new registrations - we know the rules – we will provide proper RCT data, but as for now, please respect that the medicine is prescription medicine that is prescribed only in national clinics and by certified doctors for last 13 years (...) than 13 years and before the era of modern trials and most of the evidences is not published. Doctors and clinics in Latvia use this medicine for majority of melanoma patients in Latvia for many years. In Latvia medicine is prescribed only in national clinics and by certified doctors and they have also other alternatives, so probably they know what they do. 2 years ago we started EMA (centralised EU) commercialisation process and even obtained EU commission support from Horizon2020 grant, we also

2017 Respectful Insolence

4617. Difficult Patient vs Difficult Doctor

a study that found that patients that were labeled noncompliant had underlying issues and NOT mental illness or just being difficult. Of patients that were not taking medication, the issue was that the patients could not afford the cost of the medications prescribed. The paper encouraged physicians to see if this was the issue and seek cheaper alternatives for the plan of care. (Source: ) This has been around for a long time and I have seen nurses commonly share this on social media. I have also heard

2018 Bioethics Discussion Blog

4620. Clinical Guidelines & Integrated Care Pathways for the Oral Health Care of People with Learning Disabilities

of Wales Memorial Fund Additional Funding from: MENCAP City Foundation & The Bailey Thomas Fund©2012 Faculty of Dental Surgery, The Royal College of Surgeons of England All rights reserved. No part of this publication may be reproduced, stored in a retrieval system or transmitted in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, without the prior written permission of the Faculty of Dental Surgery, The Royal College of Surgeons of England. No responsibility (...) the subjective experiences of people with learning disabilities, and their carers in relation to access to dental services (Owens et al, 2011). It concluded that although policy and guidance is available and prescriptive, it has so far been ineffective in improving access and consequently, the quality of oral health care for people with learning disabilities. A modified model of access is suggested linked to guidance by the British Society of Disability and Oral Health, to inform the commissioning

2012 British Society for Disability and Oral Health

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