Several times I have mentioned on this blog a Wired story from 2010 where they completely redesigned medical test results to make them meaningful for patients. Up until now, I didn’t know a TEDMED talk existed about this story. Well, one does and I have dutifully posted it.
The best part of this talk comes in the last two minutes. I suggest reading the Wired article and skipping to about the 13:30 part of the TEDMED talk.
Anatomy of a Doctor (via medicineblogs)
Very interesting information for those not in the medical field. I especially liked the chronology of becoming a doctor running down the left-hand side. The very last graphic at the bottom would have been much more interesting if it was doctors-per-capita around the world (not just raw numbers).
“User interface designers are beginning to realize there is no longer a need to hang on to representations of real life objects and drag them into the digital space. Digital is something else. It gives the user magical powers.” Aynne Valencia and Alfred Lui from Fjord discussing the interface of Clear, a new to-do list app Publishers and authors, take note of this quote and apply this wisdom when translating traditional texts to electronic formats. Nowhere is this wisdom more desperately needed than when developing electronic medical texts. Electronic medical record designers must also heed this advice, especially as we transition to tablets as our primary devices on the hospital wards.
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Excellent article on how companies use personal data to influence buying habits.
With a national, integrated electronic medical record system, we could leverage medical data in the same way to improve health care. Some of the large health care systems (like Kaiser Permanente and InterMountain Health) and institutions that share EMR data are already doing this. But we need greater integration and better data science to make this truly meaningful.
Thank you, Goozner, for writing about this. I was unaware this was part of the deal and I haven’t come across a mainstream article that even mentions this fact.
Update: More on this from the Washington Post (via Suitably Dyspeptic)
Last summer, after finishing the arduous task of taking our first round of board exams (USMLE Step 1), most of my classmates began their third year of med school and entered the world of clinical medicine. A small group within my class—as with most medical school classes—postponed their third year to pursue other interests. I was among this group.
Medical students can spend time away for many reasons. The most common reason is to pursue an additional degree—PhD, MPH, MBA, MSc, JD, etc. For those in combined degree programs, they usually sandwich the majority of this degree work right in the middle of their four years of medical school. Students may also take time away from med school to pursue a research year. Many fellowships exist for this explicit purpose. Students can go to places such as the NIH or CDC to work with some of the top scientists and researchers in the US for a year.
I had been interested in these opportunities from the beginning of med school. I ruled out the degree programs simply because I already have an MPH. While there are subjects I touched on during my graduate work that I would like to pursue further, I didn’t think they were worth a year away from medical school. I also looked into the NIH, CDC, and privately funded fellowships such as the Doris Duke Clinical Research Fellowship and Howard Hughes Medical Research Fellowship. These are fantastic opportunities to work at world-class research institutions. But, again, I didn’t think they were worth a year away from medical school. I already had quite a bit of research under my belt and (based on my research experiences) I knew the difficulties of trying to conduct meaningful research within a single year timeframe.
I am not trying to denigrate these opportunities; they are all excellent and potentially career-changing for most. However, for anyone considering taking time away from medical school to pursue such an opportunity, a cost-benefit analysis must be undertaken. Such analyses are difficult because they are based on many unknown factors, specifically (1) how will this experience enrich my current education and open doors for me and (2) how will adding another year or more to my medical education impact pursuits outside of medicine (i.e.—family, entrepreneurial opportunities, private career, other interests, etc). This second point is very difficult to analyze because it exists in the uncertain, abstract future.
I initially decided a year away from medical school would not be beneficial for me. I already had quite a bit of research experience. While going to work at some place like the NIH or CDC might be very cool, I felt those were experiences I would likely get a chance to have (if I wanted) later in my career. However, I am currently in the middle of a year away from medical school. So what glorious opportunity changed my mind?
Early in 2011, I released a simple iPhone app that provided mobile access to an evidence based clinical practice guideline for treating children with pneumonia. This app was based on a guideline orignially developed at Children’s Mercy Hospitals and Clinics. I worked with Dr Jason Newland on this project. While our app has enjoyed some measure of success, we envisioned something more. I was fortunate enough to find some people at Children’s Mercy who agreed with this vision and materially supported the vision.
I actually debated whether or not I should take the opportunity. It was a large risk. Unlike established research fellowships, no model for project success really existed. What if the entire project failed? I would have taken a year away from school and come up with a big, fat goose egg. What if support for the project disappeared? I could be left in the middle of an academic year not in school and with no money. However, I would also have the opportunity to be a small participant in the mHealth movement, utilizing cutting-edge technology to improve patient care.
Ultimately, I couldn’t say “no” to this opportunity. I felt it was a unique time to participate in something new that will likely change the face of health care. I may never have another opportunity like this. Things may still not work out. But, I’ve already learned a ton and had the chance to work with some incredible people—essentially, this is what any opportunity should be about.
The main project I am working on is progressing nicely through its development phases. I hope to share more about this project—the process and final result—when we are closer to releasing the end product.
This is the last panel in an interesting series about the costs of going solar broken down by state. This was my favorite panel out of the four because it clearly shows the main metric in determining whether or not to go solar—how long it takes to pay for itself. I live in Kansas where it would take 19 years for a solar investment to pay for itself. If I lived in Hawaii—time to pay for itself = 5 years—I would be seriously researching solar options.
It also highlights important economic and policy considerations. While solar costs are coming down, the real threat to adoption is the cheapness of other forms of energy. As a matter of public policy, the question becomes—do we further increase subsidies for solar power or increase costs for dirtier forms of energy through taxation?
Other countries have been using it for 20 years. Maybe we should just skip ICD-10 and begin working on delaying implementation of ICD-11.
“And while ‘gamification’ is such a horrid word that anyone saying it out loud should immediately subtract five points from their personal life score, it’s clear that fun and play are now serious business.” Helen Waters writing on Fast Co Design about the 4 Elements That Make A Good User Experience Into Something Great Gamification is a horrid and (unfortunately) pervasive word in the mHealth movement. mHealth developers should stay away from both using the word and actually trying to “gamify” their apps. Gamification is a fleeting trend and those who rely too heavily on it will become obsolete quickly.
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I remember when I was in medical school, I thought I could learn everything I needed to be great doctor. Then I wandered into the ophthalmology wing of the medical library and saw a four volume textbook on eyes. Four volumes! On just the eyes!
I realized then that there was no way you can know everything, in the same way you all will not learn everything about how to assess radiographs in the next hour. If you did, what would be the point of five year residencies? So just take away as much as you can and don’t get caught up in the details just yet. We’re only scratching the surface.
”The Tissue Series, created by Lisa Nilsson, is a collection of human anatomical illustrations using Japanese mulberry paper and the gilded edges of old books. They are constructed by a technique of rolling and shaping narrow strips of paper called quilling or paper filigree.
(via jtotheizzoe :: myedol)
“…the peer review system remains focused on deciding whether or not to publish a paper in a particular journal rather than providing (1) a high-quality evaluation of scientific merit and (2) the information necessary to organize and prioritize the literature.” Dwight Kravitz and Chris Baker from the abstract for their paper entitled, “Toward a new model of scientific publishing: discussion and a proposal.” Kravitz and Baker present an interesting analysis of the state of scientific publishing and an equally interesting proposal for reforming the publishing system. This article is a must-read for anyone who produces or consumes scientific research. Whether or not their proposed publication system is the best solution is irrelevant; right now it is more important to engage more and more people in a critical appraisal of our peer-review process. The current system is slow, cumbersome for everyone involved, creates bias in terms of what is published, and fails to take advantage of recent technological advances—most notably social media and web-based publishing. The formal scientific peer-review and publishing process is ripe for disruptive innovation. Unfortunately, some institutions—notably professional societies—make lots of money from advertising in printed journals. Wherever one group stands to lose a firmly entrenched source of income, intransigence reigns.
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Best blog post title ever?
Great short post from Stanford’s Scope blog about the increasingly intense interest in statistics. I count myself among those who are are intensely interested in statistics. (I have even considered doing a PhD in biostatistics.) I recently heard Donald Berry talk about Bayesian statistics and their applicability to clinical trials; very fascinating subject for researchers. I highly recommend checking this post out and reading their linked stories.
INTERESTS
Primary research interests include the role of monitoring and evaluation in health care quality improvement, optimal antibiotic utilization to prevent the development of antibiotic resistance, utilizing mobile technology to provide clinical decision support, and developing durable solutions for the elimination of domestic and international health disparities.
PUBLICATIONS
§ Herigon JC, Newland JG. "The role of intention-to-treat analyses in randomized trials." Infection Control and Hospital Epidemiology. 2012 Feb; 33(2): 207-8. PMID: 22227995.
§ Hersh AL, Herigon JC, Ampofo K, Pavia AT, Newland JG. “Rapid increase in use of antiviral therapy for hospitalized children with influenza during the 2009 H1N1 epidemic.” Pediatric Infectious Disease Journal. 2011; ePub May 16. PMID: 21587093.
§ Newland JG, Herigon JC. “Antibiotics provide no additional short-term benefit to surgical management of paediatric skin abscesses.” Evidence Based Medicine. 2010; 15(5): 138-139. PMID: 20643760.
§ Herigon JC, Hersh AL, Gerber JS, Zaoutis TE, Newland JG. “Antibiotic management of Staphylococcus aureus infections at US children’s hospitals, 1999—2008.” Pediatrics. 2010 ; 125(6): e1294-e1300. PMID: 20478934.
§ Herigon JC, Hersh AL, Gerber JS, Zaoutis TE, Newland JG. “Significant changes in antibiotic management of Staphylococcus aureus infections in US Children’s Hospitals from 1999-2008.” Pediatric Academic Societies’ Annual Meeting. Baltimore, MD—May 2-5, 2009. Late breaker platform presentation.
POSTER PRESENTATIONS
§ Herigon JC, Newland JG, Hersh AL. “The impact of 2009 H1N1 influenza on antiviral prescribing for hospitalized children.” Infectious Diseases Society of America Annual Conference. Vancouver, Canada—Oct 21-24, 2010.
§ Stach LM, Herigon JC, Newland JG. “Physician’s attitudes toward an antimicrobial stewardship program at a children’s hospital.” Infectious Diseases Society of America Annual Conference. Vancouver, Canada—Oct 21-24, 2010.
§ Newman RE, Herigon JC, Newland JG. “Impact of a clinical practice guideline on the management of children hospitalized with community-acquired pneumonia.” Pediatric Academic Societies’ Annual Meeting. Vancouver, Canada—May 1-4, 2010.
§ Herigon JC, Hersh AL, Gerber JS, Zaoutis TE, Newland JG. “Significant changes in antibiotic management of methicillin-resistant Staphylococcus aureus infections in US children’s hospitals from 1999-2008.” Infectious Diseases Society of America Annual Conference. Philadelphia, PA—Oct 29-Nov 1, 2009.
§ Sulieman SE, Herigon JC, Newland JG, Selvarangan R. “Impact of rapid viral cultures on management of hospitalized children with respiratory infections.” Infectious Diseases Society of America Annual Conference. Philadelphia, PA—Oct 29-Nov 1, 2009.
§ Ogden Jr RK, Stach LM, Newland JG, Herigon JC, Jackson MA. “Clinical features, management and outcome of animal bites in children.” Infectious Diseases Society of America Annual Conference. Philadelphia, PA—Oct 29-Nov 1, 2009.
§ Mangalat N, Albenberg L, Herigon JC, Newland JG, Selvarangan R, Jackson MA. “Epidemiology of Clostridium difficile Associated Disease (CDAD) in pediatric patients.” Infectious Diseases Society of America Annual Conference. Philadelphia, PA—Oct 29-Nov 1, 2009.
§ Newland JG, Hersh AL, Herigon JC. “Linezolid use at children's hospitals from 2003 to 2008.” Infectious Diseases Society of America Annual Conference. Philadelphia, PA—Oct 29-Nov 1, 2009.
§ Peterson SC, Newland JG, Jackson MA, Herigon JC. “Epidemiologic and clinical characteristics of tularemia in children.” Pediatric Academic Societies’ Annual Meeting. Baltimore, MD—May 2-5, 2009.
§ Newland JG, Stach LM, Jackson MA, Myers AL, Herigon JC, Zaoutis TE. “Successful implementation of an Antimicrobial Stewardship Program at a children's hospital.” The Society for Healthcare Epidemiology of America Annual Conference. San Diego, CA—March 19-22, 2009.
§ Rees J, Herigon JC, Rozier M, Lewis R, True W, Nolan C. “Case study of diarrheal disease in rural Dominican Republic.” Global Health Education Consortium Annual Conference. Santo Domingo, Dominican Republic—February 16, 2007.
§ Ratevosian J and Herigon JC. “Evaluation of a home based care program in Kenya: the future of community health workers.” American Public Health Association Annual Conference. Boston, MA— November 5, 2006.
§ Herigon JC. “Initial assessment of nutritional status and disease trends in rural Dominican Republic.” Boston University School of Public Health. Boston, MA—October 5, 2006.
§ Intille SS, Herigon JC, Haskell WL, King AC, Wright JA, and Friedman, RH. “Intensity levels of occupational activities related to hotel housekeeping in a sample of minority women.” International Society for Behavioral Nutrition and Physical Activity Annual Conference. Boston, MA—July 14, 2006.