bioneural.net » medicine

Medical and health app bonanza for iPhone

Bruce — Thu, 31 Jul 2008 07:28:42 +0000

A year ago I bemoaned the lack of third-party native iPhone apps and could suggest few workarounds for absent medical applications. Looking back at The medical Palm (written in 2004) serves to illustrate how stagnant the Palm platform has become—my list of software was essentially unchanged when I retired my Palm from clinical practice earlier in 2008. Although I did experiment with Windows Mobile and tried equivalent medical applications, it wasn't a relationship with a future. Following the lukewarm reception of Web apps Apple's native App Store for iPhone/ iPod touch opened on July 10, and the mobile medical landscape has been transformed in the space of just three weeks. Already we have seen the release of some impressive tools aimed at doctors, medical students, and patients/ well-being enthusiasts. iPhone apps for clinical practice Epocrates Rx (free) is a cross-platform drug formulary featuring monographs, a new visual "Pill ID" tool, an interaction checker (something I found especially useful on home visits using the Palm version), prescribing formularies (downgraded to US-only), and free wireless updates: Which "little white pill" do you mean Mrs Smith? (© Epocrates, Inc.) iChart EMR (£80) is an electronic medical record manager with patient lists, lab reports (manual or automated* retrieval), electronic prescribing*, diagnostic/ procedure codes and billing, and notes (with drawings and graphing of vitals) modules (* requires additional $US100 pa subscription for sync via a web-based application): A clinical information system in your pocket (© Caretools, Inc.) MIM (free) will appeal to referring physicians who can download non-diagnostic radiological images for ...

Clinical knowledge architect for hire

Bruce — Wed, 19 Mar 2008 08:34:04 +0000

From http://www.bioneural.net :

Dr Bruce McKenzie is now available for freelance consultancy as a clinical knowledge architect, addressing the unmet need for usable knowledge resources at the point-of-care in UK general practice. General practitioners (GPs) make more decisions in a day than a typical business executive, and these decisions cost not just money but potentially lives. It's challenging work, and you can but hope your decisions are based on good information. The problem is information overload and access to what you need when you need it: there's just too much and it's too hard to find in the context of a 10 minute consultation. As a GP for 10 years I can relate to this. I also have informatics knowledge and experience, and this puts me in a position to offer you solutions that are built the way a doctor would design them. The fact is information doesn't become knowledge by itself. After careful needs assessment raw information must be broken down and reconstructed into a usable form as part of a design process that draws upon both the art and science of information architecture. In other words it's a creative process, but it also necessitates solid technical insight into the context in which a knowledge resource will be used. With my primary care background, grasp of medical informatics, passion for writing, and practical experience in delivering concise clinical guidance for use at the point-of-care, I am now available for freelance consultancy as a clinical knowledge architect. Experience in primary care Ten years experience in several general ...

Hanging up the stethoscope

Bruce — Sat, 15 Dec 2007 11:56:35 +0000

From http://www.bioneural.net :

The week just gone marked 15 years in medicine. Two of those years were spent in New Zealand, the rest in England, and the last 10 in general (family) practice. It also marked the end of my clinical career—I'm hanging up the stethoscope and starting down a new path. I don't yet know where that path begins, let alone where it leads. But it's something I have to do. Leaving clinical practice is not a rash decision; it was in fact made during Project Koru. I had wanted to re-train in public health, but my application to do so in New Zealand was rejected. For a variety of reasons re-training within the UK National Health Service holds little appeal. So I thought I could return to general practice for a time while I considered my options. Thus I returned to the despair, hopelessness, poverty, psychosomatic illness, the reek of stale sweat and urine in nursing homes, and of cigarette smoke that lingers in your clothes and hair. And I found that I just can't do it any more. Herewith I present an Ode to general practice: I don't want to stick my finger up any more bums; I've had my fill of free-range brats and control-less mums. A look at your tonsils and throat I ask; You cough in my face as I perform this task. Stop smoking and loose weight I hear myself say, But taking some responsibility is not your way. Your job/ lover/ mother is making you ill; Nothing I can fix with patience or pill. The poverty ...

Last post from New Zealand

Bruce + Simone — Wed, 05 Sep 2007 05:46:27 +0000

From http://www.bioneural.net :

We've left Wellington and will shortly leave New Zealand and begin our journey back to the UK via Australia. Project Koru, our "year out" from life in the UK, has essentially run its course. Watching Wellington's harbour disappear from the rear view mirror as we turned into the Ngauranga Gorge for the last time was a sad moment for both of us. Wherever we go next, we'll always be Wellingtonians, as the city at the heart of the world's edge has left a permanent impression upon us. We'll miss Wellington, we've no doubts about that. We had hoped to stay, as Wellington seemed to hold reasonable answers to a few of life's basic questions. What to do? One of the primary reasons for embarking on Project Koru was to allow Bruce to make a difficult decision concerning his career. Would general practice (GP) in New Zealand be a viable alternative to the same in the UK? Should he re-train in a non-clinical discipline such as public health, or leave medicine for IT (where everyone we know personally seems to be under high pressure). The opportunity to try out GP here helped Bruce be clear about his desire to move away from clinical work, and in this respect Project Koru was an unqualified success. Bruce decided on public health as a new career path, complementary to his experience in primary care and medical informatics. Simone was quite happy to continuing working in her chosen speciality of family planning and reproductive healthcare. Where to work? Bruce applied ...

Workarounds for iPhone foibles

Bruce — Wed, 25 Jul 2007 10:45:44 +0000

From http://www.bioneural.net :

Maybe the whole concept of in-phone, out-of-date apps is itself out-of-date? Apple would seem to think so, asking iPhone users to "expand" the capabilities of their device by taking it online. Doing so has drawbacks (e.g. relying on a network signal and cost-effective data plans) and doesn't always provide a solution. In a follow-up to my previous post I look at possible workarounds for the iPhone's "missing features". People seem to be raving about how well it does what it does, so far less elegant workarounds are the only way to address the iPhones limited functionality at launch. The following list is composed from the features I considered lacking in my personal functionality wish list: The lack of an in-phone task (to-do list) manager (with Mac sync) could be addressed with the arrival of Mac OS X 10.5 (Leopard), but for now Ta-da List has an iPhone friendly view (free); The lack of text note synching (Notes does not sync) again might be addressed in Leopard. For now one way to sync notes would be to use an IMAP e-mail account with Mail on the iPhone; The lack of an in-phone password manager (with Mac sync) is a tough obstacle. I can't think of a way to overcome this that doesn't depend on network access to a secure online file store; You can't scribble quick notes or draw rough pictures using a built-in app, but maybe you don't need to if you can display photos (e.g. a map showing how to get to your house) ...

GP College confused over qualifications

Bruce — Sat, 23 Jun 2007 06:32:25 +0000

From http://www.bioneural.net :

The Royal College of General Practitioners (RCGP) remains confused over whether its Membership examination (MRCGP) is a qualification or merely an indication of "club membership". Non-Members are told not to refer to "MRCGP" and "qualification" in the same breath—although it would appear that the College can. Back in 1998 it cost me in the order of £500 to sit all four modules for Membership of the Royal College of General practitioners by examination. To continue using the designation "MRCGP" I am asked to pay £417 per annum (2007–2008 rates). I wrote to the RCGP last month as follows: I passed the MRCGP examination in 1998, and am currently applying (from NZ) to work as a locum in the UK. On the Performers List application I am asked for "medical qualifications", including qualification, institution, and date. Is the following acceptable, given that I am not a paid-up college member? Qualification: MRCGP Institution: RCGP, UK Date: 15.07.98 In other words, does the MRCGP "count" as a medical qualification? The RCGP replied as follows: Use of the designation "MRCGP" is restricted to those doctors who are currently in good standing as Members (good standing in this context is taken to mean those who have paid their annual membership subscription fee). As you are not currently a paid-up Member, I confirm that you are not eligible to use the designation "MRCGP", nor can you state that "MRCGP" is a qualification—the letters mean "Member of the Royal College of General Practitioners" and do not of themselves denote success in the College's exam (the ...

Zotero a boon for online academics

Bruce — Tue, 15 May 2007 08:58:27 +0000

From http://www.bioneural.net :

Zotero is a free Firefox extension that can automatically capture citation data from the web (e.g. Amazon books or PubMed articles). Integration with Word (Mac and PC) via a macro means it can be used to write scientific papers with formatted bibliographies (not as yet in Vancouver style, often used by medical journals). A great alternative to EndNote ($US240), or the pending OpenOffice Bibliographic project.

Google maps and public health surveillance

Bruce — Sat, 21 Apr 2007 08:08:42 +0000

From http://www.bioneural.net :

Public health doctors are apparently "hopeless" at using traditional media (BMJ 2003;327(7422):1056); it's probable that their use of new media is even worse. WhoIsSick have come up with the idea to use Google Maps to track illnesses in local communities. Perhaps this is something that public health physicians should explore as a means to both inform populations about disease patterns and for encouraging their participation in reporting? There is no need to register with WhoIsSick (as of this writing). To post a sickness anonymously you enter your city (or ZIP code; UK postcodes work too) and detail how many days since the onset of your symptoms; the symptoms you are experiencing; your age; your sex; and additional details (optional): Enter the details of your sickness Make sure to include all your symptoms! Posting this will get you added to the map, with a colour-coded disc to indicate certain common symptoms: Red for "Runny nose" linked to a UK postcode In the search tab you can look for specific symptoms in a specific location within a specific timeframe, narrowed by sex or age: Filter results according to your epidemiological interest In terms of reporting the site offers a number of features: Receive outbreak alerts by e-mail; Percentage breakdown of symptoms (in a pie chart); A graph of no. of cases against timing of sickness (potentially indicating onset of an epidemic or recovery!); A tag cloud for filtering results on a per-symptom basis. Statistics may offer comfort in knowing you're not suffering alone Imagine the consumer power that could be brought to bear if local residents ...

YouTube health videos

Bruce — Wed, 17 Jan 2007 11:48:39 +0000

From http://www.bioneural.net :

As reported by the BBC, a general practice in Wales has begun using YouTube to distribute health information videos. The Builth and Llanwrtyd Medical Practice has thus far uploaded videos relating to inhaler technique and spacer devices in respiratory disease, having a smear, and blood sugar testing in diabetes. It's a novel approach to patient education in a primary care setting, and one that might appeal to that sector of the the population seemingly infatuated with YouTube. Explaining how to use a metered-dose inhaler and spacer without props during a 10 minute consultation is challenging, and video lessons may be a valid alternative to my standard "Ask the pharmacist to demonstrate for you". There's only so much you can convey in printed leaflets, and moving pictures can convey much more detail in a very short time. Inhaler technique (Builth and Llanwrtyd Medical Practice) The practice also offers iPod-friendly QuickTime and Windows Media versions for download.

1979, 1992, 2006

Bruce — Tue, 12 Dec 2006 07:13:49 +0000

From http://www.bioneural.net :

The moving marvel. At least I think that's what it was called... the book responsible for an 11 year old boy determining to study medicine. My younger self made notes from this book and from others, in an exercise book I named "206 bones". Click thumbnail to enlarge image 206 bones (aged 11 yrs) In 1979 my teacher (Mrs Kerr?) wrote: If you can remember all this Bruce, you will certainly make it to Med. School and eventually a doctor. Thirteen years later in 1992 I graduated, on this day (12 December). That was 14 years ago, so I've now been at it for longer than the time I spent working towards it. This date also marks, more or less, 13 years since I left New Zealand and began practicing in the UK. I recently returned to NZ on the pretext of finding out if the professional grass is any greener in my homeland. I felt some guilt about having left all those years ago, despite the unplanned nature of my extended absence. New Zealand continues to experience "brain drain" as graduates head abroad to gain experience, or export themselves to the higher bidders as skilled commodities. Offsetting any feeling of guilt is the recollection of how difficult my internship was. I recall thinking that at the end of that year—if I survived it—I would have paid back my debt to society for training me. It may not be the perfect job, but a medical career has given me many opportunities and insights that I ...