| NLM Launches Mobile MedlinePlus |
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The National Library of Medicine (NLM), part of the National Institutes of Health (NIH), now offers Mobile MedlinePlus (go to m.medlineplus.gov/ on your smart phone) which allows access to an abbreviated version of Medline Plus from a mobile device. The Mobile version consists of a subset of content from the full Medline Plus website. It includes summaries for over 800 diseases, the latest health news, an illustrated medical encyclopedia and information on prescription and over-the counter medications. The Mobile version delivers the same type of authoritative, consumer-friendly, health-related information as does the “regular” MedlinePlus, which is a good, reliable site to check from your desktop computer or laptop. So I checked it out on my iPhone. What immediately impressed me was the larger than normal print, a plus for some of us! There are 3 ways to bring up a health topic – searching for it in the search box, choosing a body location/system and then “drilling down”, or bringing up the alphabetical list and choosing your topic from there. I did a sample search for “sinusitis” – the article that came up was written by the National Institute of Allergy and Infectious Diseases, an NIH entity. Then I looked up “skin aging” (not that I have a personal interest in that topic, of course!). That article was written by the National Institute on Aging, another NIH entity. Obviously, both are authoritative sources. And each article contained links to related useful information, definitely a plus. There are 2 ways to bring up information on a drug/medication – searching in the box or choosing the drug from the alphabetical list. The drug information is supplied by the American Society of Health-System Pharmacists and sponsored by NLM. All and all, I found the Mobile system easy to use. The information is helpful, easy for the lay-person to understand, and easy to read due to the larger print, larger than the usual size print on a mobile system. I would recommend this site for quick access to reliable medical information from your smart phone. And, if you have an iPhone, I still also recommend the UMMC Encyclopedia App for similar health-related information, the subject of my previous blog. |
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Submitted by: Alice McCreary, Reference Librarian
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Comments (0)January 29, 2010
| Medical Encyclopedia App for the iPhone |
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The University of Maryland Medical Center (UMMC) has produced a Medical Encyclopedia which is available as a free iPhone App. It can be downloaded at the Apple iPhone App Store or from iTunes. The App contains 50,000 pages of information that has been reviewed by medical professionals and that is updated regularly. The pages are organized by categories - symptoms, injury, disease, surgery, nutrition, special topics, poison, and test. When you retrieve an article, the date that it was last reviewed will be at the end along with the reviewer’s name and credentials. Articles contain links to related content and to medical illustrations with text. There is a search feature on the App home page, a search for a keyword or phrase returns all content relevant to that word/phrase. Once you retrieve an article, you can bookmark it or email it. There is also a link on the article which allows you to ask a UMMC expert a medical question related to your search. The expert won’t make a diagnosis but he will provide explanations of diseases and conditions and direct you to additional information. Another feature of the App is the ability to link to numerous topic-specific videos which are on UMMC’s youTube channel. To test the App out for this blog, I searched for information on “sinusitis”. First I chose the Disease category - after scrolling through a very long (but comprehensive!) list of medical conditions, I finally got to the “s’s”. Chosing sinusitis brings up an article with an overview of the topic and links to symptom, treatment, prevention, “all information”, related articles, and a list of references. As advertised, at the end of the article is the reviewer’s name as well as his or her professional credentials. The link to email the article is at the bottom of the “page”. In the Ask the Expert box you can “Get answers to your Ear, Nose and Throat questions”. The search box at the top of the App also worked fine. Typing in “sinusitis”, retrieved the same article and the same links. So you can retrieve the information that you need in 2 ways – by chosing a category and then scrolling through the list (useful if you are not sure how to spell the term) or by typing your search term directly into the search box. In my opinion, iPhone users should download this App. After all, everyone needs a medical encyclopedia from time to time – how handy to be able to easily carry one around with you. Anytime you need it, you can access current medical information, information that has been reviewed by a health professional at a reputable university medical center. And it’s free! (Note: If you don’t have an iPhone, you can access the Medical Encyclopedia at the UMMC website.) |
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Submitted by: Alice McCreary, Reference Librarian
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January 8, 2010
| Electronic Health Records and Mental Health Information |
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An article in the Journal of the American Medical Informatics Association reported on the opinions of psychiatric clinicians’ regarding their patients’ willingness to have their mental health information posted on their electronic health records. The study surveyed 120 university-based, outpatient mental health clinicians who had had 18 months experience with an electronic health record (EHR) system. Unfortunately, only 56 clinicians (47%) responded but the results were still interesting and bring up the sensitive nature of adding a patient’s mental health condition to his EHR, something that I had not considered until I read this article. I had thought of an EHR as a record of the patient’s physical health, not their mental health, but for an EHR program to be its most efficient and effective at improving the quality of healthcare, both the physical and the mental health information of the patient should be included, in my opinion. The survey points out that many patients perceive that there is a certain stigma associated with a mental health condition. This perception influences how much a patient is willing to disclose on an EHR. The survey also showed that the clinicians themselves were less willing to record highly confidential patient information on the EHR. And a majority of them did not want to include their own psychiatric record on their own EHR, a definite sign of the sensitivity of the information as well as a sign that the clinicians were concerned about the privacy and security of the electronic health record . I think the survey is a good beginning but there were some less than ideal aspects of it to be really useful. Those surveyed were from one institution only (Vanderbilt Medical Center), perhaps clinicians from another institution might have had a different opinion. Only a small number of clinicians were surveyed and less than 50% responded (56 out of 120), not enough to be very relevant. Finally, the survey took place in 2005, perhaps the clinicians’ viewpoints have changed in the last four years as they become more familiar with using EHRs. Despite these drawbacks, it is a good start, because it does point out a significant difference between clinicians involved with the physical health of a patient vs. those involved with the mental health of a patient. Not only is the psychiatric clinician less likely to participate in an EHR program, the psychiatric patient is also less willing to allow his mental health record to be included in his EHR. The report recommends that further more widespread studies be done on this topic and I agree because these issues need to be addressed as we more closer towards a National Health IT network. |
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Submitted by: Alice McCreary, Reference Librarian
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December 29, 2009
| EHR Adoption Does Not Always Lead to a Gain in Efficiency |
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A recent Milbank Quarterly study reported that many large-scale electronic health record (EHR) projects do not necessarily lead to increased efficiency. Researchers from the University College of London examined hundreds of previous studies on EHR implementation worldwide and found that: 1) EHRs often increase the efficiency of auditing, billing and other secondary functions while decreasing the efficiency of primary clerical work. 2) EHR systems are unlikely to ever achieve complete interoperability because of the different contexts involved. 3) Paper records sometimes offer greater flexibility for clinical work compared with many available EHR sytems. 4) Small, local EHR systems tend to be more efficient compared with larger systems. The bad news is, the researchers did not offer a solution for the lack of efficiency. The good news is that they did not recommend that health care providers shelve EHRs and go back to paper. |
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Submitted by: Alice McCreary, Reference Librarian
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November 17, 2009
| Quick Hits |
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The New Oxford American Dictionary has anointed “unfriend” as 2009’s Word of the Year. Um … OK. Beats “tramp stamp”, I guess. Paul Allen, co-founder of Microsoft and owner of the Seattle Seahawks and Portland Trail Blazers has non-Hodgkin’s lymphoma. I wish him well. Lexis now has an iPhone app that allows you to search for a case by citation and review its Shepard’s Summary. (Link via ResourceShelf.) Google Scholar now searches federal and state cases, plus law journals. (Link via BeSpacific.) … And speaking of hits, here’s why I’m glad, apart from the cost, why my son has chosen cross-country/track over hockey. |
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Submitted by: Dan Giancaterino, Education Services Manager
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November 12, 2009
| Tick Bite Causes Serious Allergy to Red Meat |
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I read an interesting article in the Washington Post recently about a 57 year-old man who had three near fatal anaphylactic reactions to something he ate. At first it was thought that he was suddenly allergic to some type of seafood, but after the third reaction, when, unlike the other 2 times, he had not eaten any seafood, his ailment became even more mysterious. It took 6 months to uncover the culprit. According to 2 recent studies, one in the US and one in Australia, he is not the only one with the same diagnosis. It seems that a tick bite can trigger the production of an antibody that cross- reacts with a sugar present on red meat. And not just any tick bite, it has to be a bite that causes a significant skin reaction. Yes, he had had a tick bite a month before his first serious reaction and yes, he had eaten some form of red meat before all three reactions. I found this all very curious and decided to search PubMed to find the 2 medical studies referred to in the Post article. Initially, I ran a simple search using the terms “tick allergy red meat”. A check of the Details feature showed that PubMed searched for both the text terms and the appropriate MeSH headings: (“ticks”[MeSH Terms] OR “ticks”[All Fields] OR “tick”[All Fields]) AND “hypersensitivity”[MeSH Terms] OR “hypersensitivity”[All Fields] OR “allergy”[All Fields] OR “allergy and immunology”[MeSH Terms] OR (“allergy”[All Fields] AND “immunology”[All Fields]) OR “allergy and immunology”[All Fields]) AND red[All Fields] AND (“meat”[MeSH Terms] OR “meat”[All Fields]) The Australian study was the only one that came up, I still had to find the US study. I checked the Australian article to see what MeSH terms were used to index it and re-ran my search using these MeSH terms: “Food Hypersensitivity” “Ticks” “Meat”. But again the only article that came up was the Australian one. Using clues from the Post article, I used the Limits feature of PubMed to search for the author “Commins, Scott” and the journal title “The Journal of Allergy and Clinical Immunology”. This time I found the US study. And, serendipitously, I also found a more recent article (October 2009) also out of the University of Virginia and written by two of the same researchers as the other US article and involving a similar topic. Note that all 3 articles require payment/subscription to view the full-text, but you can view the bibliographic citation and abstracts of the articles for free at PubMed. Moral #1 - I found the Post article fascinating but almost too bizarre to believe so to satisfy myself, I set out to find the reports of the medical studies that supported it. As always, PubMed came to the rescue. Moral #2 – watch those ticks, not only can they give you Lyme Disease, they can give you a possibly fatal allergic reaction to red meat! |
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Submitted by: Alice McCreary, Reference Librarian
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October 30, 2009
| PubMed Redesign |
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The National Library of Medicine (NLM) has redesigned the interface to PubMed. It takes a little bit of investigating to figure out where everything is now but I think I have pretty much figured it out. You need to choose Advanced Search to access the Limits feature. All the Limits that were there with the old interface are there now except for a couple of changes. The Added to PubMed date limit is no longer available, you can only limit by Publication date. The pull-down menu is no longer there, you need to type in the publication date ranges. You also need to choose Advanced Search to access Details. I previously blogged about how useful Details is to verify what terms you are actually searching for in PubMed, so you really do want to know how to find this feature with the new interface. The searchable MeSH database can be accessed either by using the pull-down menu on PubMed’s home page or under More Resources towards the bottom of PubMed’s home page. To get to Display Settings, you must first run a search in the database. Once your result list comes up, you can access Display Settings at the top of the page. Using that feature, you can select various search result display formats (Summary, Abstract, MEDLINE), the number of citations that you want to be displayed on one page, and how you want your results sorted. Note that the Citation format is no longer available, the components of that format (showing the MeSH indexing terms, for example) have been combined with the components of the Abstract format. Also note that the maximum number of citations that can be displayed on one page is now 200 (previously it was 500). To get to the Send to option, you also have to run a search first. Then you can choose to send your results to a File, to the Clipboard, or to E-mail them. Note that you can no longer send your results to your printer. After you choose how you want your results to display, you must use your browser’s File/Print command to print. I liked the old send to printer option because the printout would contain the PubMed logo on it. After the new interface went online, I emailed NLM about the loss of the send to printer option and they replied that if you don’t choose the text format option when you choose how to display your results, your results will still print with the PubMed logo. Seeing is believing so I tried it and it did work. I had been afraid that all the Internet graphics would complicate the printout but they were somehow (and miraculously, to me) stripped out. If you want more comprehensive information about the new PubMed interface, you can access NLM’s excellent training manual, which was recently updated to reflect all the changes. Their manual is very easy to follow. It takes you step by step through all the various PubMed features and is a great teaching resource. Or if you want hands-on experience searching PubMed, you might want to take my PubMed class. All in all, once you get used to the new interface, I think it is more streamlined and efficient than searching PubMed the old way. |
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Submitted by: Alice McCreary, Reference Librarian
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October 19, 2009
| Nightmare |
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Doesn’t this headline make you want to clench just about every part of your body? ‘Known Software Bug’ Disrupts Brain-Tumor Zapping I’ve written about this before. It’s always scary to trust the machine. |
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Submitted by: Dan Giancaterino, Education Services Manager
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October 6, 2009
| Camden Health Information Exchange |
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A recent article in the Philadelphia Inquirer reported that the three major health systems that serve Camden, NJ are joining with local doctors to share the health records of their patients, if the patients give their permission for this data sharing. This system, called the Camden Health Information Exchange, could be operating by winter. Cooper University Hospital, Our Lady of Lourdes Medical Center and Virtua Health are the hospitals that will be sharing patients’ medical information, which includes hospital discharge summaries, lab results, x-ray results, and patient medications. Only about 200 passwords will be issued. The exchange will cost $210,000 in the first year and $85,000 for each of the next two years. The article reported that “these efforts are being spurred by nearly $49 billion in federal stimulus funds for health-information technology” but it is not clear whether the total cost of the Exchange will be paid for by the stimulus funds or whether the cost will be partly funded by the hospitals themselves. Jeffrey Brenner, the physician who pushed for the Exchange through the Camden Coalition of Healthcare Providers, reported in the article that a Camden citywide database of hospital discharges shows that 13 percent of patients are responsible for 80 percent of the cost. This is a particularly interesting statistic to me, having worked for 16 years at West Jersey Hospital (now Virtua). It makes sense to me because we certainly had a bunch of repeat patients (the same patients being admitted over and over again). Anyway, the Exchange should cut those costs by reducing unnecessary tests which should also result in better patient care. Anthony Mazzarelli, medical director of the emergency department at Cooper was quoted in the article “In order to provide the best possible care, every physician at every health system wants as much information [about their patient] as possible”. This new Exchange should help with that. |
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Submitted by: Alice McCreary, Reference Librarian
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September 3, 2009
| $1.2B in Grants for Health IT Adoption |
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The White House’s website reports on the upcoming availability of grants worth almost $1.2 billion to help hospitals and health care providers implement and use electronic health records (EHRs). The grants will be funded by the American Recovery and Reinvestment Act of 2009 (PL 111-5) and provide incentives to doctors and hospitals who use EHRs. The grants that were announced by press release on August 20, 2009 will be available in 2010. They include $598 million to establish 70 Health Information Technology Regional Extension Centers and $564 million to “States and Qualified State Designated Entities” (SDEs). The Regional Extension Centers will provide doctors and hospitals technical assistance in acquiring, implementing, and using EHRs. The SDEs will support the development of methods for sharing health information within the slowly growing nationwide system of networks. These grants “begin the process of creating a national, private, and secure electronic health information system” said David Blumenthal, National Coordinator for Health Information Technology. Vice President Biden’s announcement also said that the Department of Health and Human Services will provide additional assistance to health care providers through the Health Information Technology Research Center (HITRC). The Center will work with the Regional Extension Centers to share best practices in EHR adoption and use. I will not bore anyone who may be reading this by referring to any of my previous blogs regarding privacy/security issues with EHRs. I am accepting the fact that the National Health IT Network is coming and getting past my issues with security. In fact, I wish the IT Network was here right now because I need to contact my doctor about a problem with a prescription and when I call the office all I get is a busy signal. Oh how nice it would be to be able to email her, which certainly better be possible with the IT Network! |
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Submitted by: Alice McCreary, Reference Librarian
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