Free Cloud-Based EMRs

I ran across this post by Paul Levy the other day:

"By the way, speaking of electronic medical records and meaningful use, we cannot fail to mention the upstart company Practice Fusion.  Focusing mainly on independent physician practices, Practice Fusion CEO's says, "We’re effectively the Salesforce for doctors, and the Facebook for health.”  Doctors can sign up for free for an EMR that will meet the meaningful use criteria, making them eligible for the $44,000 in federal incentive payments.  The service offers labs, e-prescribing, scheduling, charting, and billing.  The revenue model is based on advertising by labs, pharmacies, and drug companies who want to be seen by these medical decisions-makers.  The company promises that the basic EMR services will always be free, but I suspect that future revenue may also come from enhanced services."

http://runningahospital.blogspot.com/2012/06/this-is-not-cold-fusion.html

What a thought that we now have fully functional and integrated EMRs hosted entirely in the cloud that are free for the end users (docs and clinics).  Since it's cloud based, you also don't need to have servers to host data and don't need to worry about updates to a proprietary piece of software.  

I wonder what a product like this will do for the free clinics and other small primary care practices in our country that previously may have been resistant to adopting electronic record systems because of prohibitive up front costs (of both time and money)!

Unintended Consequences / Vaccination Struggles

So it appears vaccination coverage isn't just a developed country problem and docs across the world are dealing with some of the exact same problems:  rumors swaying public opinion.

Whether is is the (completely discredited) connection between MMR vaccines and Autism or now the connection that Pakistanis are making between polio vaccination campaigns and foreign spies, these stories are hurting those kids who are getting ill with preventable diseases.

Take a look at this CNN article for the whole story (video included).  In a nutshell, the local media highly published a story that the US was (in part) able to gain access to the Bin Laden compound through a fake vaccination scheme and this has since engendered massive distrust of vaccination initiatives.  Perhaps the greatest tragedy in this case is Pakistan is one of several countries where polio is still endemic, so failed vaccination campaigns mean kids will grow up paralyzed.  Pretty heavy consequences indeed.

April Newsletter

The April edition of our quarterly newsletter, Publicly Speaking, is out with some great ideas about how you can get involved internationally. If you would like any additional information from any of the authors let us know and we'll happily connect you! 


Have a great week! 
CGPH - Publicly Speaking (April 2012 Newsletter)

Public Health Education Resource

If you've been looking for a public health education resource the information below is a great place to start. Should you have any questions we'd happily put you in contact with the creators. Feel free to e-mail me at lauren.page.black@gmail.com should you wish to speak with them.

Have a great week!
Lauren-Page
AMA Committee on Global and Public Health 

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In response to an informal needs assessment administered by the Regional Medicine-Public Health Education Centers Initiative (an effort to better integrate public health content and skills into medical education supported by AAMC’s cooperative agreement with the Centers for Disease Control and Prevention), and the AAMC’s Organization of Student Representatives (OSR), we have developed a modular power point presentation that we hope will be a helpful resource for students and faculty at your institution.

These slides were developed for medical students and faculty. They provide an overview of the relationship between medicine and public health, review why public health is relevant to medical education and careers, and include recommendations and resources to improve public health content in medical education.

Users may select slides and incorporate them into their curricula, presentations, and other efforts to advocate for improving public health perspectives at their institutions.

The slides are divided into seven sections to facilitate their use:

•What is public health? What is the relationship between medicine and public health?

•What determines health?

•How is public health important to your training and careers?

•What do we know about student perspectives on public health in medical education?

•Enhancing public health in your curriculum and training

•Specializing in Public Health and Preventive Medicine

•Resources

•CDC Professional Student Programs and the Epidemic Intelligence Service

The slide-set can be accessed online at www.aamc.org/rmphec at the bottom of the right-hand column under Student Resources.

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There’s more to food culture than just restaurants

Actor Wendell Pierce, best known for his roles on HBO’s “The Wire” and “Treme,” is now a proud business owner in his hometown of New Orleans. After opening a convenience store this winter, he and a local business partner plan to open a string of grocery stores beginning this summer. His aim is two-fold: to encourage economic growth in New Orleans and to bring nutritious and affordable food to a food desert.

The lack of grocery stores in New Orleans is a problem made more prominent post-Katrina. The majority of the 21 supermarkets that do exist today are not close to the areas hardest hit. A 2007 survey from Tulane showed that although 58% of low-income residents do not have access to a car, 60% must travel a considerable distance (3 miles) to reach a grocery store.

At first, Pierce intended to come back to New Orleans and just build houses but soon recognized that convenient access to healthy food was necessary for the successful revitalization of the neighborhood. “You start to realize all the parts of infrastructure that are needed,” he comments on his newfound awareness of the complex inter-connectedness of basic necessities.

With the opening of Sterling Farms, his new full-service grocery store, Pierce hopes to revive the sense of community surrounding food that he says characterized much of his childhood. In addition to all the expected services of a grocery store, Sterling Farms will address the specific needs of this community by providing a free shuttle for shoppers and a monthly cookout to raise community funds. Since losing a bid to launch the stores in his own neighborhood of Pontchartrain Park, Pierce has looked elsewhere. Sterling Farms will be located across the Mississippi in Marrero, LA, a neighborhood in which a quarter of households earn less than $25,000 a year. In lieu of a fixed rent, he will pay 2% of sales that exceed $9 million yearly.

Pierce acknowledges the parallels between the lessons he is learning and his personal frustrations with systemic malfunction and those depicted in “The Wire” and “Treme.” “It’s life imitating art, and art imitating life,” Mr. Pierce said.

Check out the full New York Times article at: http://www.nytimes.com/2012/03/07/dining/wendell-pierce-to-open-a-grocery-store-in-new-orleans.html?hp

The Birth of a Movement

My love for Lady Gaga is no secret, but since the launch of her new “Born This Way Foundation,” I have even more reason to sing her praises. Last month, Lady Gaga shared the stage of Sanders Theatre at Harvard with Oprah Winfrey to launch what she calls a movement to “challenge meanness and cruelty by inspiring young people.” It is more than an anti-bullying campaign but a youth empowerment campaign that aims to change an entire culture.

The three pillars of her campaign are safety, skills, and opportunity. She aims to create a culture in which every person feels safe, has the skills to stand up for one another, and uses the opportunities that arise to spread the message of tolerance.

Probably my favorite moment from the launch event was when Alyssa, a very brave young person who was a member of the opening panel, was asked to explain what she does at school. She said, “I try to set an example...then the rest will follow.” Telling stories of success will be an important part of what the foundation does.

There has been a lot of attention paid recently to cyber-bullying because of its visibility, but statistics show that the most common type of bullying is still face-to-face. Incidentally, the foundation is partnering with Blue State Digital to use social media to spread the message of love and acceptance.

I applaud Lady Gaga’s efforts to reach out to experts, disseminate information, and begin interdisciplinary dialogues. Her partners include the MacArthur Foundation and the Berkman Center for Internet and Society at Harvard. Secretary of Health and Human Services Kathleen Sebelius, Deepak Chopra, and psychologist Susan Swearer all participated in her launch event.

This foundation intends to improve the health and well being of young people from the bottom up. Lady Gaga understands this will take time. Tell a friend and spread the message!

Watch the launch of the Born This Way Foundation and read some notes from “The Kinder and Braver World Project” from the Berkman Center.

The International Medical Brain Drain – Are we to blame?

I read an interesting New York Times article today addressing the shortage of doctors in the developing world. There are some disturbing statistics:

- In the US, there is 1 doctor for every 416 people vs. 1 for every 23,000 in Zambia

- The median salary of a surgeon in New Jersey is $216,000 in New Jersey vs. $24,000 in Zambia

- One in 4 doctors in the US is trained overseas

Is America to blame for the shortage of doctors in sub-Saharan Africa? There is a great demand in the US for doctors, especially primary care physicians: statistics project a shortage of 200,000 doctors in this country in 10 years. With high salaries, innovative technology, and enticing immigration laws, the US attracts more foreign doctors every year than Britain, Canada, and Australia combined. Some states have legislation that allows foreign doctors to stay in the US after residency if they would practice in underserved or rural communities here. So far, more than 8,500 doctors have done so. But what is a gain to one country is a loss to another.

A 2008 article in the Lancet suggested that that the active recruitment of medical professionals from Africa be viewed as a human rights violation. It described recruitment agencies that woo medical workers through advertisements, workshops, e-mails, and even text-messages.

But for some doctors, it is the plain reality of practicing in their homeland that causes them to leave. Dr. Kunj Desai, from Zambia, now a resident in surgery in New Jersey, described repeated instances of senseless death due to lack of resources. “We were just pretending to be doctors,” he said of his time at University Teaching Hospital in Lusaka, Zambia.

There is some international funding for training and retention of local doctors but Western aid agencies often hire local talent to do research, not see patients, contributing to an “internal brain drain.”

The solution probably involves a combination of more high-quality training programs and hospital resources, higher salaries, and better working conditions for foreign physicians in the developing world. What the US can do instead of recruit foreign physicians is to contribute to the existing infrastructure for the delivery of medical care in other countries. On the issue of teaching, I am particularly interested in exchange programs for residents, which allow both parties valuable training experiences.

Check out the full article at:

http://www.nytimes.com/2012/03/11/magazine/america-is-stealing-foreign-doctors.html