| Understanding Medical Words |
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Although it may look a little juvenile, I think this is a useful tutorial from the National Library of Medicine which helps you understand medical terminology. It shows how to put words together and how to break them apart into prefixes, suffixes, and word roots. It links to the MedlinePlus dictionary and encyclopedia so you can look up the meaning of a medical term. It covers some common medical abbreviations and links to MedlinePlus’s list of medical abbreviations as well as lists of various word parts. Throughout the tutorial are simple quizzes to see what you’ve learned as you proceed through the screens. Check it out and let me know if you found it useful or not. |
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Submitted by: Alice McCreary, Reference Librarian
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Comments (0)June 16, 2009
| MedlinePlus Search Clouds |
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Recently MedlinePlus introduced a nifty feature called search clouds. These “clouds” are arranged alphabetically and display the top 100 searches run using the MedlinePlus search box, with the size of the cloud representing the number of times that term was searched. A term’s exact search ranking can be obtained by placing your cursor over the term. The “collection” of clouds are updated each week day. Clicking on a search term cloud runs a search for the term in MedlinePlus and links the searcher to the results. The National Library of Medicine created this search cloud feature to provide insight into the search behavior of MedlinePlus users and to gauge current public interest in major health issues. For example, today (6/16/09) one of the larger clouds (most searched term) is “swine flu” (ranked 1out of 100). For any blog readers unfamiliar with MedlinePlus, it is a good starting place to obtain information about a disease or condition, whether or not you search the site or use the search clouds. |
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Submitted by: Alice McCreary, Reference Librarian
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June 1, 2009
| ONC to Develop Online PHR Model |
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The Office of the National Coordinator for Health IT (ONC) plans to develop an online personal health record (PHR) model to help the general public understand PHRs. A recent notice in the Federal Register announced the plan to create this model which will “be developed to allow presentation of important PHR facts and policies to consumers, allow consumers to understand and cosistently compare PHR service provider policies with others, and focus on the key information that may influence decisions and choices of PHR service provider”. The notice also stated that “ONC is taking steps to establish that useful facts about PHRs and PHR privacy information be made available to consumers so they can make informed decisions about selecting and using PHRs”. ONC will test consumer understanding about the PHR model in six locations across the nation which cover the four U.S. geographic regions. The model will be revised as ONC gets feedback by interviewing six to seven participants at each of the six locations. These participants will be selected according to census statistics for race/ethnicity, age, marital status, gender and income so that all groups in that location are covered. Also the sample of participants will include those that are familiar with and those that are unfamiliar with PHRs as well as participants who manage chronic health issues for themselves or others. Gaining the public’s trust in the privacy of their online health information is essential to the success of the entire National Health IT program as I have blogged in the past (specifically discussing patient privacy and the success of England’s National Health Service IT Programme, which is ahead of ours in development). The ONC model plan seems like a good start. I am particularly impressed to see that the PHR model will not start out as “carved in stone” but will be continually revised according to the feedback received. |
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Submitted by: Alice McCreary, Reference Librarian
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May 5, 2009
| Public Opinion Regarding Electronic Health Records |
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A recent NPR/Kaiser Family Foundation/Harvard School of Public Health survey determined that 75% of adults think it is either very important or somewhat important for their health care providers to use electronic health records. But ironically, 59% of those surveyed are not too confident or not at all confident that their personal health information will remain confidential when placed online. So the majority of people surveyed think it is a good idea even though it is not secure. Interesting. The survey was conducted by telephone over 10 days in March. A sample of 1,238 randomly selected adults (18 and over) were polled. All groups have been weighted to reflect their actual distribution in the country. |
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Submitted by: Alice McCreary, Reference Librarian
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April 20, 2009
| Technological Changes in the Medical Laboratory |
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The California Healthcare Foundation recently released a report entitled Under the Microscope: Trends in Laboratory Medicine which was prepared for them by the Lewin Group. Having spent 16 years as a Medical Technologist in a hospital laboratory, I found this report quite interesting, especially seeing how much the lab has changed since I left to go to graduate school in 1987. The report is very comprehensive regarding current trends in laboratory medicine as well as anticipated future trends that will affect the lab. To point out what an important player the laboratory is in patient healthcare, the report’s introduction states that an estimated 70 percent of medical decisions regarding prevention of disease, patient diagnosis and subsequent patient treatment involve laboratory tests. As healthcare stakeholders increasingly demand more “scientific evidence for clinical decision making”, the lab becomes more and more important. What I found most interesting about the report was the discussion of three electronic tools (which obviously were not around when I worked in the lab!) which have the capacity to improve the quality, safety, and efficiency of patient healthcare and also the cost-effectiveness of patient treatment - the electronic health record (EHR), computerized physician order entry capability (CPOE), and a computerized decision support system (CDSS). The EHR can decrease orders for overused tests and increase orders for underused tests by providing laboratory test guidelines on the computer screen as a physician accesses his patient’s EHR. A CPOE tool which connects the ordering physician with the laboratory information system (LIS) increases accuracy and efficiency in laboratory workflow and also decreases turnaround time for lab tests. This can result in higher quality healthcare because a patient can receive medical treatment sooner, as his physician is alerted to any abnormal lab tests more quickly. A CDSS flags abnormal test results, reminds the physician to order preventive tests, and minimizes redundant test orders, thus contributing to better patient care and increased cost-effectiveness. The report points out that the major problem, at present, with these 3 electronic tools is that the data standards may differ from one LIS to another. This requires special software, “middleware”, to allow data exchange between clinicians, hospitals, laboratories, etc. This is one of the issues that must be fixed, if the National Health IT agenda is to succeed. When I left the lab some 21 years ago, discussion had just started about how computers could be used in the lab. It was interesting to me to see how far the lab has come and what the future holds for those working in the laboratory medicine field. And how crucial solving the data exchange problem is before the lab can become an efficient and cost-effective part of our future National IT Program. The full report can be accessed from this webpage. |
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Submitted by: Alice McCreary, Reference Librarian
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March 12, 2009
| Patient Involvement Helps |
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A recent study shows that the participation of patients in the use of electronic health records (EHRs) might improve the effectiveness of the system. The study was conducted by Harvard Medical School, Harvard Vanguard Medical Associates and Brigham and Women’s Hospital (abstract of study, fulltext not available without a subscription). Harvard Vanguard Medical Associates (HVMA) is a group practice that has had patients’ records online for the last 12 years. The researchers choose 21,860 HVMA patients who were overdue for colorectal screening and 110 doctors who treated those patients and then split the patients and the doctors into sample and control groups. They sent personalized letters (complete with an educational pamphlet, fecal occult blood test kit, and instructions for direct scheduling of sigmoidoscopies/colonoscopies) to the sample group of patients. A sample of their physicians received a pop-up reminder that their patients were overdue for their colorectal screening tests. This reminder “appeared” when the doctor accessed his patient’s EHR. After 15 months, about 44% of the patients who received the direct reminder went for screening, compared to 38% who didn’t receive a direct reminder. Reminders to the doctors resulted in an increase in screening rates only among patients with 3 or more primary care visits with their physicians (59.5% vs. 52.7%). The study showed that repeat online reminders to a patient’s physician can be used to foster better healthcare. And more importantly, that reminding patients directly, which in this case resulted in an increase in colorectal screening, showed one way that electronic health records can foster better healthcare in the future if they are used to empower patients to be more proactive about their own healthcare. |
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Submitted by: Alice McCreary, Reference Librarian
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February 19, 2009
| Online Services Let Patients Seek a Second Opinion |
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A recent Newsweek article discusses online second opinion services which offer a patient a consultation from a medical specialist based on the patient’s medical record which he has sent to the specialist via either fax, snail mail, or e-mail. The cost averages $500 to $1000. After the patient pays for the service, it takes about 2 weeks for him to receive the second opinion online.
One service, Partners Online Specialty Consultations (POSC), has been online for nine years. Since then about 5,000 patients in the U.S. have used it. The other “major” second opinion service, based at the Cleveland Clinic, started about 8 years ago and has served about 1,700 patients. Johns Hopkins Medicine, another player, has done only about 50 consults but hopes to expand their service in the future. And the Mayo Clinic is planning on getting into the second opinion “business” shortly.
Not all second opinion services require that the patient’s own physician participate – the Cleveland Clinic “delivers” their consultation directly to the patient and to his doctor. On the other hand, POSC “delivers” their’s to the patient’s physician only. In either case, the opinion is posted on a “secure” website where either the patient and/or the patient’s doctor can view it. Which brings up the problem of security and privacy of the patient’s online medical report, which I have blogged about in the past and won’t blather on about here.
Another problem, besides the security issue, is that most insurance companies do not cover online second opinions. Cigna does cover them but for “certain” patients only. With the economy as unstable as it is today, I would expect that a lot of patients will be less willing to pay $1000 out of their own pocket when they either have lost or are worried about losing their job. And that’s assuming that they have an extra $1000 to spare anyway.
Having been in the medical field in my “previous life” (Medical Technologist in a hospital Blood Bank for 16 years), I am a big fan of second opinions. So once I am convinced that an individual’s online personal health record is secure and once more insurance companies agree to cover the cost of these online second opinions, I think this will be an excellent patient service. |
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Submitted by: Alice McCreary, Reference Librarian
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February 5, 2009
| They’ve Nailed “Omniscience”. They’re Working on “Omnipresence”. |
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Yesterday Google announced that they’ll help us to share our location with our friends and family (and them). Today comes word that Google will enable us to stream data from medical devices such as heart rate monitors to Google Health. Once Google decides to go after “omnipotence” they’ll be just like You-Know-Who. |
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Submitted by: Dan Giancaterino, Internet Librarian
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January 12, 2009
| PHRs Projected to Save $21 Billion Annually |
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The Center for Information Technology Leadership (CITL) recently published its research findings on the value of Personal Health Records (PHRs) and estimated that they could save $21 billion annually in the United States (full report). Their research also indicated that PHRs could result in an annual net value of $19 billion based on a 10 year rollout and a usage rate of 80% of Americans. The study was supported by “unrestricted” funding from the HealthCare Information Management and Systems Society (HIMSS), Google, InterComponent Ware, Inc., Kaiser Permanente, Microsoft Corporation, and Partners HealthCare System (where CITL is based). CITL studied the financial value of four types of PHR systems: provider-tethered (healthcare delivery organizations that offer PHRs to patients), payer-tethered (healthcare insurance companies that offer PHRs to their subscribers), third-party (aggregators who compile their users’ medical data but who use a manual communication channel), and interoperable systems (regional aggregators of a patient’s medical information who consolidate all of the patient’s information into one record which can then be accessed through automated electronic data exchange anywhere nationally). All of these systems function to provide patient medical information collection and sharing (sharing a patient’s test results and medications), tools for patient self-management of their health issues (for example, how to manage a chronic condition and helpful hints to quit smoking), and healthcare information exchange (online appointment scheduling, prescription renewals, pre-doctor visit questionnaires, and even online doctor “visits”). The study found that, of the 4 types of PHR systems, interoperable PHRs are the greatest value. This is the investment that will insure the success of the national healthcare system by allowing communication of patient information among various healthcare “stakeholders” (doctors’ offices, hospitals, health insurance providers, and the patient himself). As Blackford Middleton, M.D., and senior author of the report, said in CITL’s press release “PHRs have the potential to dramatically improve efficiencies in our healthcare system”. The study found that healthcare cost savings would accrue to both payers and providers, with payers seeing the majority of the savings. (Hmmmmm, would health insurance companies then lower their rates?). Another finding in the study – which I personally find attractive, is the amount of money which could be saved by e-visits to doctors just by decreasing patient travel time. They estimated a savings of 7.6 hours per year, per patient. Thinking about that made me think about how an e-visit would also prevent the spread of a contagious disease by a sick patient who is coughing and sneezing while sitting in his doctor’s waiting room. That reminds me of the one time that I had the flu and knew that I had to see my doctor so that I would get better, but I also worried about how many people in the waiting room that I might infect. And of course, the other side of that have been the times that I have gone to see the doctor when I wasn’t contagious and wondered who had what in the waiting room and what I might catch. Both of my scenarios would be prevented by an e-visit! Because I have been fairly negative about PHRs in some of my previous blogs (one example), I thought it was about time to report on the positives, mainly the tremendous cost savings and the improved management of an individual’s health. There are still many barriers to the adoption of PHRs nationwide and there is that old privacy issue which the study also touches on, but I don’t think there can be any doubt of the necessity of a National Health Information Technology system where all Americans have their PHRs online and accessible by all the healthcare professionals nationwide who have a “stake” in that American’s health. NEWSFLASH: On January 8, President-Elect Obama pledged to have the medical records of all Americans electronic within five years. |
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Submitted by: Alice McCreary, Reference Librarian
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December 19, 2008
| HHS Secretary’s Blog |
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I recently (yes, I know, better late than never) discovered (stumbled upon) Mike Leavitt’s blog. He is the Secretary of the Department of Health and Human Services. I must say that I am impressed that a member of the President’s cabinet has a blog that he writes himself so that he can report directly to the public on today’s health issues. He even takes the time to answer some of the questions and comments posted on his blog. And to help us find his blog there is a link from the HHS’s home page.
Currently on his blog are entries on trips that he took to Iraq and Pakistan complete with pictures. He observed first hand the medical treatment of our military and talked with many of the doctors and nurses involved in their treatment. Makes for interesting reading! In his Pakistan entries, he discusses the relationship between terrorist organizations and health care. From one of his posts, “In order to cultivate support among the local people of that region, terrorist groups work through non-governmental organizations friendly to their cause to undermine the credibility of the government in providing basic services like health care. They then set up clinics and actually provide services to the people themselves. Terrorist organizations have discovered the power of health as a tool in securing the loyalty of local people.” I never considered this connection but after reading Secretary Levitt’s blog it certainly does makes sense. Archives of his posts go back to August 2007 and cover a multitude of health-related and Department-related topics. There is also a list of links to these topics so you don’t need to go through all the archives if you are just interested in one topic. One of the topics that I blog about frequently are the issues involved with EHR’s (electronic health records). This link assesses Secretary Levitt’s posts on Health IT (of which EHR’s are a part), comments from the public, and his responses.
I find all of this very refreshing – a blog written by an Administration Cabinet Member reporting directly to the people in his own words. I would love to see more upper level government employees do the same. And I surely do hope some version of this blog is continued by the next Secretary of HHS! |
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Submitted by: Alice McCreary, Reference Librarian
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