Princess Health and Open Letter to Minnesota's Heath Commissioner Dr. Edward Ehlinger on ill-informed health IT puff piece. Princessiccia

Princess Health and Open Letter to Minnesota's Heath Commissioner Dr. Edward Ehlinger on ill-informed health IT puff piece. Princessiccia

Chair Adam Duininck Commissioner Kevin Lindsey Commissioner Lucinda Jesson Edward Ehlinger healthcare IT myths healthcare IT risk Minnesota Heath Commissioner minnpost.com

Gusty 04:20 Add Comment

Minnesota's Heath Commissioner Dr. Edward Ehlinger penned a puff piece on EHRs entitled "Electronic health records advance quality care for all Minnesotans" (Minn Post, 4/23/15, http://www.minnpost.com/community-voices/2015/04/electronic-health-records-advance-quality-care-all-minnesotans).

It constains all the usual baloney (being kind here) about this technology:

It starts with this:

As Minnesota�s health commissioner, I work to improve the health of all Minnesotans. As a physician, I�m dedicated to providing the best care possible to patients. Secure electronic health records help achieve both goals by enhancing the safety, effectiveness, and efficiency of our health care system. With that in mind, I have been concerned to see some recent pushback on Minnesota�s requirement that all health care providers use electronic health records (EHR) by 2015 ... All Minnesota patients, whether they visit a small clinic, need mental health treatment, or receive care from multiple providers, stand to benefit from EHRs and the improved care coordination they make possible.

"Pushback", he writes?

The implication seems clear - 'fear mongering' by Luddite clinicians is responsible.  See my March 2012 post "Doctors and EHRs: Reframing the 'Modernists v. Luddites' Canard to The Accurate 'Ardent Technophiles vs. Pragmatists' Reality" at http://hcrenewal.blogspot.com/2012/03/doctors-and-ehrs-reframing-modernists-v.html on that antediluvian, tired old issue.

Note also the terminology "stand to benefit" - a typical weasel phrase just in case things don't work out as intended.

Not mentioned are the harms.

Rather than plow through yet another puff piece by someone either misinformed or just way behind the current medical literature on this experimental technology, I provide the letter I wrote to Dr. Ehlinger and several other Minnesota cabinet members, including Commissioner Kevin Lindsey of the Dept. of Human Rights, Commissioner Lucinda Jesson of the Dept. of Human Services, and Chair Adam Duininck, Chair of the Metropolitan Council:

The letter:

From: Silverstein,Scot
Sent: Saturday, April 25, 2015 7:00 AM
To: health.commissioner@state.mn.us
Cc: info.mdhr@state.mn.us; dhs.info@state.mn.us; public.info@metc.state.mn.us
Subject: "Electronic health records advance quality care for all Minnesotans" - really?

Congratulations Dr. Ehlinger.  With your puff piece "Electronic health records advance quality care for all Minnesotans" (http://www.minnpost.com/community-voices/2015/04/electronic-health-records-advance-quality-care-all-minnesotans) you just flunked my introductory course in Medical Informatics.

Kindly refrain from writing on subjects about which your knowledge clearly lags common knowledge in healthcare information technology (IT).

You must not know about the following, although you should have known, or should have made it your business to know, about these at the very least:

1. ECRI Institute Deep Dive Study on Health IT risks (2012) http://www.healthit.gov/facas/sites/faca/files/STF_Deep_Dive_Health_Information_Technology_2014-06-13.pdf
2. Letter to ONC from 37 Medical Societies (January 2015)       http://mb.cision.com/Public/373/9710840/9053557230dbb768.pdf
3. Joint Commission Sentinel Events Alert on Health IT (March 2015)    http://www.jointcommission.org/assets/1/18/SEA_54.pdf
4. Accenture - Despite Increased Use of Electronic Medical Records, Fewer U.S. Doctors Believe It Improves Health Outcomes (April 2015)                     www.businesswire.com/news/home/20150413005148/en/Increased-Electronic-Medical-Records-U.S.-Doctors-Improves

I don't mean to sound insulting, but it is earned on your part.  My mother is deceased in 2011 as a result of an EHR error.

When did you plan on informing the citizens of your state about the risks of bad health IT?

Not giving your citizens opportunity for informed consent regarding the use of these medical devices in their care seems a violation of human rights.  The most impacted are the disadvantaged, who go to organizations with lesser budgets to make the IT work safely, I add.

Sincerely,

Scot Silverstein

----------------------------------------------------------------

Scot M. Silverstein, MD

Consultant/Independent Expert Witness in Healthcare Informatics (May 2010-present)

Adjunct faculty in Healthcare Informatics and IT (Sept. 2007-present)
Assistant Professor of Healthcare Informatics and IT, and Director, Institute for Healthcare Informatics (2005-7)
Drexel University
College of Computing and Informatics
(formerly College of Information Science and Technology)
3141 Chestnut St., Philadelphia, PA 19104-2875

I did not mention the horrible track record of breaches (e.g., as retrieved by query link http://hcrenewal.blogspot.com/search/label/medical%20record%20privacy).  Close calls, maiming and death is enough for one letter.

It is truly unnerving to see a physician responsible for the heath of the citizens of an entire state so seriously misinformed.

-- SS

Princess Health andSouthern Kentucky physician expands his in-school clinics; already in Russell County, will be in Adair County next year.Princessiccia

Princess Health andSouthern Kentucky physician expands his in-school clinics; already in Russell County, will be in Adair County next year.Princessiccia

children children's health health insurance school health school nurses schools youth

Gusty 07:03 Add Comment

Dr. Eric Loy
(Columbia Magazine photo)

An entrepreneurial physician in Southern Kentucky has developed a way to deliver school health services that could have a broader impact on communities.

Cumberland Family Medical, based in Burkesville, has clinics at the five schools in Russell County and now has a deal to do likewise with the four in adjoining Adair County.

Dr. Eric Loy, who owns the clinic, "said that the agreement could have an important impact on the community both short term, by helping create a healthier and more focused student body; and long term, by creating a culture where people get acclimated to seeing doctors and nurses for physicals and regular checkups on a consistent basis," Wes Feese reports for The Adair Progress.

�We have a chance to change the culture of health care in Kentucky,� Loy told the Adair County Board of Education, which voted to spend $80,000 next year on the clinics. That is "roughly the same cost the district currently pays for school nurses," Feese reports. "If the trial run next year is successful, both parties will have options to continue the agreement."

"Cumberland Family Medical will pay two-thirds of the nurse expense and will bill the insurance of the patient," Toni Humphress reports for the Adair County Community Voice.

School Supt. Alan Reed complimented the dedication and service of the county�s school nurses but said costs to employ them were �soaring,� Feese reports. Reed said of Loy's plan, �This is kind of a novel approach, and from all we�ve seen, we really like it. It cuts down on time and any barriers for a kid getting health care.�

Loy agreed, saying, �A lot of times that�s the barrier, that it�s hard [for parents] to miss work.�

School principals said sick students may have to sit in an office or lobby all day because working parents are unavailable to come pick the students up and take them to a doctor. "Director of Pupil Personnel Robbie Harmon said that this move could have a bigger long-term impact on the community than any project he�s worked on in his time in the school system."

Loy's in-school clinics are manned by a full-time nurse practitioner who travels between schools, and is overseen by a physician. "Loy said that all forms of insurance would be accepted, and that all children would be seen and treated, regardless of their ability to pay," Feese reports. "He also said that the clinics could help out with insurance enrollment."

Adair County had one of the state's highest percentages of people without health insurance until the federal-state Medicaid program was expanded under federal health reform. The uninsured rate has dropped dramatically, but some families are still without health coverage.

Princess Health andAnthem gives $140,000 for 3-county program to cut smoking by pregnant women, still at 21.9% in Ky., among highest in U.S..Princessiccia

Princess Health andAnthem gives $140,000 for 3-county program to cut smoking by pregnant women, still at 21.9% in Ky., among highest in U.S..Princessiccia

pregnancy smoking tobacco tobacco prevention

Gusty 13:57 Add Comment

Health departments in Christian, Hopkins and Madison counties will start a program called Giving Infants and Families Tobacco Free Starts, with a $140,000 grant to the state health department from the Anthem Foundation.

The GIFTS program was created to help decrease the number of women who smoke during pregnancy and reduce exposure to secondhand smoke for the pregnant woman and her infant, a state news release said. Smoking before and during pregnancy is the single most preventable cause of illness and death among mothers and infants, according to the federal Centers for Disease Control and Prevention.

�Tobacco use is a serious problem in Kentucky, but it is an even more serious issue for women who smoke during pregnancy,� said Dr. Ruth Shepherd, director of the state health department's Division of Maternal and Child Health. �Smoking during pregnancy and infant exposure to secondhand smoke create numerous risks for babies, including pre-maturity and low birth weight, and risks for developing certain conditions like asthma.�

Smoking rates among pregnant Kentucky women dropped from 26.3 percent in 2004 to 21.9 percent in 2013, but that is still among the highest rates in the U.S. In 2013, 13.3 percent of Kentucky births to smoking mothers were premature, compared to 10.2 percent of births to mothers who did not smoke. Even more striking were these numbers: 13.6 percent of babies born to smokers had low birth weight, compared to only 7.5 percent of those born to non-smokers.

The GIFTS program includes a screening tool for assessing tobacco dependence; screening for depression, social support and domestic violence; individualized counseling and support; referral to a service that helps smokers quit; and educational materials, including relapse prevention and the risks of secondhand smoke exposure in the home.

�Reducing the amount of tobacco use and secondhand smoke exposure is not only crucial for improving the health of our state,� state Health Commissioner Stephanie Mayfield said in the news release. �We are thrilled to receive this grant from the Anthem Foundation and look forward to building on the success of GIFTS and working toward reaching our state�s health goals.�

Princess Health andSmokers using electronic cigarettes are less likely to quit smoking than those who don't use the devices, California study finds.Princessiccia

Princess Health andSmokers using electronic cigarettes are less likely to quit smoking than those who don't use the devices, California study finds.Princessiccia

cigarettes e-cigarettes research smoking tobacco tobacco prevention

Gusty 13:55 Add Comment

The sudden increase in use of electronic cigarettes has prompted questions about whether they actually help people quit smoking. A study published online in the American Journal of Public Health found that individuals who use e-cigarettes are actually less likely to quit smoking than those who do not. In Kentucky, 24 percent of adults and 41 percent of those aged 18 to 29 reported using e-cigarettes, according to a Kentucky Health Issues Poll.

The study, conducted by researchers from the University of California San Diego School of Medicine, discovered that smokers who use e-cigs are 59 percent less likely reduce cigarette use and 59 percent less likely to stop smoking altogether, compared to smokers who have not used e-cigs.

"Based on the idea that smokers use e-cigarettes to quit smoking, we hypothesized that smokers who used these products would be more successful in quitting," said Wael Al-Delaimy, professor and chief of the Division of Global Public Health in UC-San Diego's Department of Family Medicine and Public Health. He said the research showed the hypothesis was false, and more studies are required to find out why these people can't stop smoking. "One hypothesis is that smokers are receiving an increase in nicotine dose by using e-cigarettes," he said.

E-cigs don't contain tobacco, but smoking them releases ultra-fine particles and volatile organic compounds such as heavy metals. The study also found that women and those who smoke daily are more likely to have tried e-cigarettes.

Princess Health and Do Slower-digesting Carbohydrates Make Us Feel More Full?. Princessiccia

Princess Health and Do Slower-digesting Carbohydrates Make Us Feel More Full?. Princessiccia

Gusty 03:00 Add Comment

One of the most common pieces of advice in the health-nutrition world is that we should focus our carbohydrate intake on slowly-digesting carbohydrates, because they make us feel more full than rapidly-digesting carbohydrates. Rapidly-digesting carbohydrates, such as potatoes, stand accused of causing us to overeat, resulting in obesity, diabetes, and many other chronic ailments. Is this true?
Read more �

Princess Health andNew treatment for symptoms of advanced Parkinson's disease approved by FDA and unveiled at UK.Princessiccia

Princess Health andNew treatment for symptoms of advanced Parkinson's disease approved by FDA and unveiled at UK.Princessiccia

drug treatment FDA Parkinson's disease research

Gusty 16:45 Add Comment

Portable infusion pump used
to deliver Parkinson's drug

The University of Kentucky unveiled a new treatment for people with advanced symptoms of Parkinson's disease at a news conference April 21 and invited one of the first patients to participate in the clinical trial to share how this treatment has improved his function and productivity.

The new, trademarked, treatment, Duopa, provides a continuous 16 hour dose of levodopa, which is the "gold standard" drug to treat Parkinson's disease ,using a special gel preparation, is put directly into the small intestine by a portable infusion pump. It was developed by AbbVie Inc. and approved by the U.S. Food and Drug Administration in January.

"This treatment extends our ability to manage the signs and symptoms" of Parkinson's, said Dr. John Slevin, professor of neurology and vice chair of research at UK's Kentucky Neuroscience Institute. Slevin also worked with international investigators to test this treatment and is the lead author of the study, which is published in the Journal of Parkinson's Disease.

Parkinson's is a chronic and progressive disease of the nervous system that is characterized by motor symptoms such as tremors,slowness, stiffness and impaired balance and coordination. It can also cause non-motor symptoms such as sensory deficits, cognitive difficulties and sleep problems.

The cause of Parkinson's is unknown and there is no cure, but it is known that the disease process involves the death of nerve cells in the brain that produce dopamine, a chemical that sends messages to the part of the brain that controls movement and coordination.

Slevin said that there are many challenges in treating the symptoms of Parkinson's as it progresses. In addition to the continued loss of nerves in the brain, he said levodopa looses its effectiveness over time and the dose level begins to fluctuate. He also noted that over time patients will get a side-effect from the drug called dyskinesia, or involuntary muscle movement.

Another challenge, which he said prompted the development of this treatment, is that the muscles that control digestion are also affected by the disease, which creates an inconsistency in the blood level of levadopa that can be turned into dopamine in the brain.

This new treatment alleviates this challenge by placing the drug directly where it is absorbed in the intestine, allowing "The blood level, and thereby brain level (to remain) constant and that reduces the probability of having intermittent dyskinesia," Slevin said.

Marion Cox

"We are extremely pleased with the results," Slevin said in a press release. "Patients with advanced Parkinson's disease treated via this new method demonstrated marked improvement in symptom fluxuations and reduced dyskinesia."

Marion Cox, a 70-year-old Georgetown farmer and former real estate developer, who has had Parkinson's for 16 years, participated in the clinical trial for three years and said that this treatment has given him a "new lease on life."

"It was the best thing that ever happened to me. The improvements have been that great," Cox said. Later saying, "I can do anything I want to do. I can horseback ride. I've got a team of horses that I drive. I've got lots of farm equipment, excavating equipment that I drive. Before I went on the trial I was still doing those things, but unbelievably slow."

Dr. Michael Karpf, Becky Cox, Marion Cox, Dr. John Slevin

Dr. Michael Karpf, UK's vice president for health, said he was proud to be part of a major health center committed to doing clinical trials: "What UK HealthCare has to do is to not (just) practice the standards of care, we have to move the standards of care forward." Cox will be the first patient in Kentucky to receive Duopa after FDA approval.

Becky Cox, Marion's wife of 25 years, said the treatment "saved him from an early retirement." She noted that before Duopa, he had been taking an "unmanageable" number of pills to treat his symptoms, but now, after he hooks up to the pump in the morning, "It is a set it and forget it kind of thing. ... He is off and running like he always used to be, so that has been a great blessing."

Because this treatment involves an invasive procedure and because most people with Parkinson's disease respond well to oral medication initially, Slevin said this treatment is meant for those with advanced Parkinson's symptoms. He also said the cost for this treatment is still being determined, but it was already approved by Medicare. He noted that the next step will be to train other medical centers in how to deliver this treatment.

The National Parkinson Foundation website says 1 million people in the U.S. have the disease, with 50,000 and 60,000 new cases diagnosed each year. Kentucky has 14,000 people with it, Tony Bucalo, Parkinson's neuroscience account executive at AbbVie, said after the news conference.

Princess Health and2015 TYS10K.Princessiccia

Princess Health and2015 TYS10K.Princessiccia

Gusty 18:18 Add Comment

The 2015 TYS10K marked the absolute fastest and most PB-riddled performance by H+P.  Ever.

It was a massive success from both a team and individual standpoint.  We are so appreciative to the Canada Running Series for providing us with this outstanding opportunity to run fast, and for all the other teams and competitors that gave our athletes runners to chase along the way.  Here's how we did:

TEAM RESULTS:

Men's Team Results

The H+P Men's team was the top team with an average time of 33:08.  Top 5 came from Adam Hortian, Brendan Hancock, RunnerRob, Greg Dyce and Ahmed Ahmed.

The H+P Mix team also got in on the action, placing 4th with an average time of 40:00.  Top 5 came form Erik V, Simon, Jonathan, Justin and Lucas.

Women's Team Results

The H+P Women's team also came out on top with an average time of 40:53.  Top 5 came from Steph Hortian, Kailey Haddock, Payton Thiel and Helen Broom.

Mixed Team Results

The H+P Women's team actually place 4th out of all the top mixed teams, while our Mixed team cam in just behind with an average time of 41:44.

INDIVIDUAL RESULTS

H+P Rankings Page

Full Results 

Adam Hortian was in first for the team with an outstanding 6th place OA finish, running a new personal best

of 30:24.

Brendan Hancock came in next, running PB of 32:34, good for 25th OA.

RunnerRob was 3rd for the team with a very solid 33:20, a new PB.

Greg Dyce posted a surprise, marriage-driven PB of 34:30.

Ahmed Ahmed came in with an outstanding personal best of 34:45.

Coming in next for the team was Luke Ehgoetz with a new PB of 36:13, our top masters runner!

Nick Burt battled a toe injury and posted a very solid 37:10.

Steph Hortian was our first female to cross the line.  She ran 37:19, good enough for 10th OA and a new club record!

Kailey was our second female to cross the line, posting an outstanding 4 minute PB of 38:44.

Simon Gonslaves was in next, posting an outstanding 39:04 PB!

Jonathan Fugelsang came in just after Simon with a great 5 minute PB of 39:52.

Emily Hunter crossed with a massive PB of 40:59.

Coming back form concussion, Justin Buis posted a 5 minute personal best of 41:14!

Payton was in next for the team with a massive 4 minute personal best of 43:24.

Linda was in next with a 3 minute personal best of 43:32.

Helen followed with a 4 minute personal best of 43:56.

Andrew posted a very solid personal best of 44:00!

Paul showed his fitness is coming into form, posting a time of 44:11.

Tracy was in next, our TOP masters female, running a PB of 45:02.

Dragan was in next with another PB of 46:21.

Kristin Marks posted an outstanding personal best of 49:24.

Candice Shrigley posted a great personal best of 51:27!

Heather was in next with a very solid person best of just over 1 hour.

See ya next year TYS10K!

#cantwontstop