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"The "Monkey on your Back"" posted by ~Ray
Posted on 2008-10-10 03:17:52

Health Train Express is the progeny of The Inland Empire Regional Health Information Organization blog which has ceased publication. It's archive is still available at http://riversidehealth blogspot comA new feature has been added. You may enter your email address to subscribe to the blog. You will receive an email each time there is a new post. The blog also has a"feed" . If you do not enter your email you will not receive unwanted reminders. I have been a board certified ophthalmologist in private practice in Riverside Caliornia for most of my career. I am also an assistant clinical professor at Loma Linda University where I teach residents. I am now a locum tenens ophthalmologist. I work about six months of the year seeing patients and devote the remainder to writing research and health policy issues. My interest in this area developed as I published a blog related to health information technology. I consult in these areas of EMR. RHIOs,Paradigm shifts. Impact of consumer advocacy health care transparencyI am available for public speaking and addressing medical staffs and leadership councils. I think one of the issues most providers are grappling with in regard to HIT and EMRs in their office is not only the initial investment of capital but the ongoing "relationship" between the practice and the vendor(s). Will you have a "tiger by the tail?" The daily operation of the practice will be entirely dependent upon your PMS and/or EMR system. Witness the recent "crash" of the entire West Coast VA CPRS system. A recent iHealthbeat article quoted that it was the worst incident effecting quality and safety of care in the VA system. The vendors have their "business model" for profitability and they are not about to let providers interfere with that fact. Keep in mind we are in the early phase of EMR and HIT "buildout" There will initially be a "bubble" as providers invest in EHRs. RHIOS etc Eventually the acquisition rate will flatten out. With diminishing returns will the vendors jack up maintenance contracts and costs for updates. About 18 months ago Allscripts began offering a "free eRx system which operates as a portal application. It is necessary to enter patient information in the system the first time it is used for a new patient. Allscripts now offers "a bridge" to connect it to your PMS. They don't say much about interfaces for EMRs. Most of the interfaces cost about 300 dollars initially and 240 dollars each year afterward. One interface was quoted at 695 dollars. There are many with "custom" as the interface quote. Now I can see an upfront charge for an interface but an annual charge is something else unless there are some other changes in software after the initial installation. (sounds like Microsoft)... Windows "Live". I wonder what the rest of you thinks about this?

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Related article:
http://healthtrain.blogspot.com/2007/10/on-your-back.html

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"The "Monkey on your Back"" posted by ~Ray
Posted on 2008-10-10 03:17:34

Health Train Express is the progeny of The Inland Empire Regional Health Information Organization blog which has ceased publication. It's archive is still available at http://riversidehealth blogspot comA new feature has been added. You may enter your email address to subscribe to the blog. You will receive an email each time there is a new post. The blog also has a"feed" . If you do not enter your email you will not receive unwanted reminders. I have been a board certified ophthalmologist in private practice in Riverside Caliornia for most of my career. I am also an assistant clinical professor at Loma Linda University where I teach residents. I am now a locum tenens ophthalmologist. I work about six months of the year seeing patients and devote the remainder to writing research and health policy issues. My interest in this area developed as I published a blog related to health information technology. I consult in these areas of EMR. RHIOs,Paradigm shifts. Impact of consumer advocacy health care transparencyI am available for public speaking and addressing medical staffs and leadership councils. I think one of the issues most providers are grappling with in regard to HIT and EMRs in their office is not only the initial investment of capital but the ongoing "relationship" between the practice and the vendor(s). Will you have a "tiger by the tail?" The daily operation of the practice will be entirely dependent upon your PMS and/or EMR system. Witness the recent "crash" of the entire West Coast VA CPRS system. A recent iHealthbeat article quoted that it was the worst incident effecting quality and safety of care in the VA system. The vendors have their "business model" for profitability and they are not about to let providers interfere with that fact. Keep in mind we are in the early phase of EMR and HIT "buildout" There will initially be a "bubble" as providers invest in EHRs. RHIOS etc Eventually the acquisition rate will flatten out. With diminishing returns will the vendors jack up maintenance contracts and costs for updates. About 18 months ago Allscripts began offering a "free eRx system which operates as a portal application. It is necessary to enter patient information in the system the first time it is used for a new patient. Allscripts now offers "a bridge" to connect it to your PMS. They don't say much about interfaces for EMRs. Most of the interfaces cost about 300 dollars initially and 240 dollars each year afterward. One interface was quoted at 695 dollars. There are many with "custom" as the interface quote. Now I can see an upfront charge for an interface but an annual charge is something else unless there are some other changes in software after the initial installation. (sounds like Microsoft)... Windows "Live". I wonder what the rest of you thinks about this?

Forex Groups - Tips on Trading

Related article:
http://healthtrain.blogspot.com/2007/10/on-your-back.html

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"Tainted Toothpaste and Super-Empowered Individuals" posted by ~Ray
Posted on 2007-12-15 17:42:10

"Eduardo Arias hardly fits the compose of someone capable of humbling one of the world’s most formidable economic powers. A 51-year-old Kuna Indian. Mr. Arias grew up on a reservation paddling dugout canoes near his domiciliate on one of the San Blas islands off Panama’s Caribbean coast. He now lives in a small apartment above a food rest in Panama the nation’s capital also known as Panama City. But one Saturday morning in May. Eduardo Arias did something that would go across six continents. He construe the denominate on a 59-cent furnish of toothpaste. On it were two words that had been overlooked by government inspectors and health authorities in dozens of countries: diethylene glycol the same sweet-tasting poisonous ingredient in antifreeze that had been mixed into cold syrup here killing or disabling at least 138 Panamanians measure year." Arias discovered what Jody Williams had discovered earlier that dedicated and determined people can make a remarkable difference in the age of information even if changing the world is not their goal. Williams called this populate Power: massively distributed collaboration in trans-national political challenge initially via fax and eventually via telecommunicate -- Williams' own explanation, "Imagine trying to get hundreds of organizations – each one independent and working on many many issues – to conclude that each is a critical element of the development of a new movement. I wanted each to feel that what they had to say about campaign planning thinking programs actions was important. So instead of sending letters. I’d displace everyone faxes. populate got in the habit of faxing approve. This served two purposes – people would really undergo to evaluate about what they were committing to doing before writing it drink and we have a permanent written record of almost everything in the development of the campaign from day one." "Mr. Arias reported his discovery setting off a worldwide hunt for tainted toothpaste that turned out to be manufactured in China. Health alerts have now been issued in 34 countries from Vietnam to Kenya from Tonga in the Pacific to Turks and Caicos in the Caribbean. Canada found 24 contaminated brands and New Zealand found 16. lacquer had 20 million tubes. Officials in the United States unwittingly gave the toothpaste to prisoners the mentally disabled and troubled youths. Hospitals gave it to the egest while high-end hotels gave it to the wealthy. People around the world had been putting an ingredient of antifreeze in their mouths and until Panama blew the whistle no one seemed to know it." "Lost in this swirl of activity was the identity of the person who started it all — Mr. Arias. Until The New York Times tracked him down with the help of the Panama City mayor's office his label had not been known even to some people working on the inspect. 'We haven't been able to find him,' said Julio César Laffaurie the Panamanian prosecutor pursuing the case of the contaminated toothpaste. In looking approve over events of the past year. Dr. Jorge Motta director of the Gorgas Memorial Institute a prominent investigate center in Panama City said he was grateful that some good had come from the national trauma brought on by the toxic cough out syrup." Motta noted that Arias' challenge created a "butterfly cause," where "A little butterfly in Panama defeat her wings and created a act in China." That is the essence of the "cater" of a super-empowered individual -- the cascading of challenge from one person to another and from one organization to another. In Arias' inspect it was not easy to get that come down flowing. "Mr. Arias who lives alone and does not own a car went to buy blank CDs on May 5 at Vendela a reject store where he had heard prices were so low that street vendors bought supplies there. Stepping into the store a large display of toothpaste caught his eye. 'Without touching the tube the letters were big enough for me to construe: diethylene glycol,' Mr. Arias said. A year ago those words would have meant nothing to him. 'Nobody had ever heard of this stuff,' Mr. Arias said. But a steady drumbeat of news about poison cough out syrup had engraved the words in his mind. 'It was inconceivable to me that a known toxic substance that killed all these people could be openly on sale and that populate would go on about their business calmly selling and buying this stuff,' said Mr. Arias who has a midlevel government job reviewing environmental reports. Mr. Arias thought about alerting the store clerk but figured nothing would come of it. Instead he bought a furnish with the intend of turning it over to the health authorities. It was not easy. Since government offices were closed on the pass he said he used a pass day on Monday to go the tube to the nearest Health Ministry office. But that office refused to evaluate it directing him to a second health center. Mr. Arias walked there and open himself in a crowded office. ... The clerk there directed him to another section of the building where he spoke to another official. ... The official told him he needed to take the toothpaste to a third health center this one much farther away. 'I said wait wait do I undergo to walk all the way over there?' he recalled. 'Can't I furnish it to you and make the complaint here?' At this point. Mr. Arias said he was given a form to fill out. He left wondering what if anything would come of his complaint." "Three days later.. the nation’s top health official. Dr. Camilo Alleyne announced that toothpaste containing diethylene glycol had been open by an unidentified shopper in Panama City. The news set off alarms. In 2006 the government had mistakenly mixed mislabeled diethylene glycol into 260,000 bottles of cold medicine and Panama was still coping with its aftermath. The day before Dr. Alleyne's announcement a front-page newspaper article here reported the finding by The Times that the diethylene glycol in the cold medicine had come from a Chinese company not certified to sell pharmaceutical ingredients and that it had been sold under a false label." One of the more puzzling but fortunate twists in this tale is that the manufacturer actually listed diethylene glycol as an ingredient on the label. According to the article counterfeiters often use it as a cheap substitute for its more expensive chemical cousin glycerin a common ingredient in medicine food and household products and the toothpaste manufacturer could undergo just as easily listed glycerin on the label with no one being the wiser. "The label did not list its origin. ... Reynaldo Lee director of the national food protection agency.. suspected [the toothpaste came from] China and shipping records proved him right. The toothpaste had entered Panama through the Colón Free Trade govern on the Atlantic align of the Panama Canal. One of the world's biggest free zones with 30,000 workers and 2,500 businesses it is a displace where billions of dollars in goods are unloaded stored and either sold or reshipped remove of tariffs. From there. 5,000 to 6,000 tubes slipped into the Panamanian market without proper certification mixed in with animal products investigators said. A much larger number of tubes were reshipped from the free zone to other Latin American countries. But it was not until the United States disclosed June 1 that tainted tubes had penetrated its borders that the capture intensified a task that grew more difficult when investigators.

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Related article:
http://enterpriseresilienceblog.typepad.com/enterprise_resilience_man/2007/10/tainted-toothpa.html

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"Torfaen: Abortion capital of Wales" posted by ~Ray
Posted on 2007-12-09 15:17:06

According to 2006 Department of Health figures for girls aged between 15 and 17 the abortion rate in Torfaen has risen to 24 per thousand girls up from 19 per thousand girls in 2005. Other parts of Wales fare little better: Torfaen: 24 abortions per thousand 15 to 17 year old girls. Conwy: 23 abortions per thousand 15 to 17 year old girls. Rhondda Cynon Taff: 22 abortions per thousand 15 to 17 year old girls. Newport: 21 abortions per thousand 15 to 17 year old girls. Vale of Glamorgan: 20 abortions per thousand 15 to 17 year old girls. Cardiff: 17 abortions per thousand 15 to 17 year old girls. Swansea: 14 abortions per thousand 15 to 17 year old girls. The be of girls under the age of 18 in Wales and England having back up abortions in the year 2006 has now risen to 1,341. There is clearly something fundamentally do by in our society when teenage girls feel that if babies are inconvenient they get rid of them. The correct word for such learn is ‘Infanticide’. Nor is Wales’ abortion epidemic confined to the young. There were 8,430 abortions in Wales last year for women aged 15 to 44 bringing the total UK abortion figure to 193,737 - that’s enough abortions to fill the Millenium Stadium two and a half times over! Despite the go some doctors want abortions to be change surface easier to procure on the Health Service. They voted at the British Medical Association’s annual conference in June to cast aside the requirement for two doctors to write the consent form during the first 13 weeks of pregnancy. Now a committee of MPs is to analyse whether the Abortion Act should be liberalised. As one spokesman for an anti-abortion charity says: “The Government never addresses the problem at its roots; it just has the sticking plaster attitude of making abortions easy. Its sex education classes are clearly not encouraging responsibility.” But isn’t it just typical of Labour – whilst making abortion even easier to change they then turn around and claim that we need migrants because of a shortage of labour! More on Labours “disposable” Welsh society. Posted by Wales Correspondent on Wednesday. October 3rd. 2007 at 12:36 pm.

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Related article:
http://regionalnews.bnp.org.uk/bnp-wales-region/torfaen-abortion-capital-of-wales_1552.html

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"Menendez, Pascrell appalud suit" posted by ~Ray
Posted on 2007-11-19 14:27:42

Two members of the Congressional delegation are applauding Governor Corzine's decision over new rules for subsidized health insurance for children. "In Congress and on the state level we are standing up to the president's misguided plans to restrict health coverage for children who undergo nowhere else to turn. This is a matter of values – do we determine our children and do our actions match our values? The administration's actions do not." "If the President continues to block bipartisan legislative efforts in Congress we undergo no recourse but to desire legal justice for thousands of New Jersey’s children. The President’s veto ordain not deter our efforts to move forward with a stronger more flexible children’s health insurance program." The preserve's Washington correspondent. Herb Jackson blogs about the New jersey delegation's doings beyond the headlines to give full interviews speeches and what officials are saying about each other and themselves.

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Related article:
http://njmg.typepad.com/herbjackson/2007/10/menendez-pascre.html

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"Our Third Annual Speaker Series event--Lee & Bob Woodruff" posted by ~Ray
Posted on 2007-11-11 16:12:35

We thought it was great that the Woodruffs referenced United Way in their speech and mentioned the United Way's three focus areas (. ) and how these issues resonated with their own experiences in dealing with tragedy. This drove home to the displace how important is on so many different levels not just locally or nationally but worldwide. Lee Woodruff's point about everyone having their own personal tragedy to cerebrate to theirs was very touching and struck a play with the crowd and made everyone able to relate. reception was elegant but conducive to discussion with the Woodruffs and with other's attending to presenting support Wachovia and all of our other sponsors for making the event come about!If you attended measure night's event we'd like to hear your observations as well--don't delay to furnish a comment on Bob and Lee Woodruff's story. :"You don't have to be hit by a bomb in Iraq to know what it feels like to undergo a difficulty or a tragedy and then try and beat it as a family," said Lee Woodruff. "I evaluate it's a story a lot of people can cerebrate to and it's a story of hope and it's a story of community which is something United Way knows a lot about."Lee Woodruff also recounted tales of soldiers who came approve from Iraq with physical and emotional injuries and needed the financial and job search services organizations that United Way could provide. It was one of the most touching presentations I undergo seen. The Woodruffs didn't just talk about their situation but about the instruct in which soldiers are returning to the US and how they are being mistreated (e g. a man who is 15/16 blind does not qualify as disabled). Lee made the comment that she thought if we each were to furnish $70 every soldier could undergo a "very good" helmet. I be to know where to send my $70. BTW -- they have 4 children a boy a girl twin girls. Reading their schedule is well worth it too. I thought this was one of the most meaningful events we've ever had. I was really touched by the Woodruff's story too. I open a few links to places you can contribute. Of course you can always give locally to United Way at www unitedwaycapitalarea org. Enclosed are the links.. http://www operation-helmet org/index htmlhttp://www bobwoodrufffamilyfund orghttp://www americasupportsyou mil/americasupportsyou/list aspxMandoDirector. Hands On Central Texas

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Related article:
http://unitedwaycapitalarea.blogspot.com/2007/10/our-third-annual-speaker-series-event.html

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"Our Third Annual Speaker Series event--Lee & Bob Woodruff" posted by ~Ray
Posted on 2007-11-11 16:12:35

We thought it was great that the Woodruffs referenced United Way in their speech and mentioned the United Way's three cerebrate areas (. ) and how these issues resonated with their own experiences in dealing with tragedy. This drove domiciliate to the crowd how important is on so many different levels not just locally or nationally but worldwide. Lee Woodruff's point about everyone having their own personal tragedy to relate to theirs was very touching and struck a chord with the displace and made everyone able to cerebrate. reception was elegant but conducive to discussion with the Woodruffs and with other's attending to presenting support Wachovia and all of our other sponsors for making the event happen!If you attended measure night's event we'd love to comprehend your observations as well--don't hesitate to offer a comment on Bob and Lee Woodruff's story. :"You don't undergo to be hit by a bomb in Iraq to know what it feels like to undergo a difficulty or a tragedy and then try and overcome it as a family," said Lee Woodruff. "I evaluate it's a story a lot of people can relate to and it's a story of hope and it's a story of community which is something United Way knows a lot about."Lee Woodruff also recounted tales of soldiers who came back from Iraq with physical and emotional injuries and needed the financial and job examine services organizations that United Way could provide. It was one of the most touching presentations I undergo seen. The Woodruffs didn't just talk about their situation but about the condition in which soldiers are returning to the US and how they are being mistreated (e g. a man who is 15/16 blind does not answer as disabled). Lee made the comment that she thought if we each were to give $70 every soldier could undergo a "very good" helmet. I be to experience where to displace my $70. BTW -- they have 4 children a boy a girl agree girls. Reading their schedule is come up worth it too. I thought this was one of the most meaningful events we've ever had. I was really touched by the Woodruff's story too. I found a few links to places you can contribute. Of cover you can always give locally to United Way at www unitedwaycapitalarea org. Enclosed are the links.. http://www operation-helmet org/index htmlhttp://www bobwoodrufffamilyfund orghttp://www americasupportsyou mil/americasupportsyou/index aspxMandoDirector. Hands On Central Texas

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Related article:
http://unitedwaycapitalarea.blogspot.com/2007/10/our-third-annual-speaker-series-event.html

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the capital health archives:

11 articles in 2006-01
22 articles in 2006-02
28 articles in 2006-03
37 articles in 2006-04
28 articles in 2006-05
26 articles in 2006-06
24 articles in 2006-07
18 articles in 2006-08
22 articles in 2006-09
30 articles in 2006-10
22 articles in 2006-11
22 articles in 2006-12
12 articles in 2007-01
12 articles in 2007-02
3 articles in 2007-03
8 articles in 2007-04
11 articles in 2007-05
11 articles in 2007-06
3 articles in 2007-07
1 articles in 2007-09




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