Cardiology

I overhead two women chatting about symptoms the other day while they were surfing WebMD on their respective iPhones for diagnoses - their discussion was as public and non-chalant as if they were shopping. I mused over this for a minute, unsure if I should be disturbed or not, and then found myself wondering which URLs really are the "go-to" sites for health information. An answer was only a click away via Google search at eBizMBA.com.

Way back in January, Phil Baumann, RN, provided an empathic answer to the question/concern that was on everyone's mind then: "Yeah Twitter seems great and all, but can you use it for anything useful in healthcare?" We followed up with him to see how 2009 went.

As the mean BMI in the U.S. edges higher, I thought that a discussion of 2 recent analyses regarding lipids was pertinent to the season.

HITECH says covered entities must be able to monitor and record every time that patient data is accessed, enabling the entity to comply with the new notification requirements should unauthorized access occur. Will the new rules end up restricting the efficient exchange of data that is crucial to providing high-quality healthcare?

As EHRs are widely adopted and the quantity of information about a patient expands dramatically, does provider liability increase even if the quality of care is vastly improved?

Large organizations with mobile workers, such as hospitals, face diminished productivity when communication is inefficient and its employees are unable to locate their coworkers in a timely manner.

Bravo. The government finally has its healthcare IT priorities straight. Unfortunately, it won't be able to achieve them.

Below are select statistics on the prevalence, incidence, and mortality rates associated with angina pectoris in the US.

For those interested in health information technology, there is now an excellent, new, powerful website about this topic called the Huffington Post Investigative Fund. In their most recent report, "Can Cleveland Clinic Be a Model for Digital Medicine?" they discuss how this hospital system has failed to recoup their $100 million investment to date.

Individuals with mild to moderate coronary heart disease, treated with intensive medical therapy alone, were no more likely to die from a heart problem after five years than those who also had an angioplasty procedure.

Researchers from Imperial College London have found the trigger that causes inflammation and artery damage in patients with atherosclerosis.

Insulin resistance may affect long-term cardiovascular outcomes in type 1 diabetes and results indicate that insulin resistance is directly related to decreased heart and vessel function and appears to impair capacity to exercise.

Glucose intolerance during pregnancy predicts an increased likelihood of postpartum metabolic syndrome. In turn, cardiovascular risk factors at three months postpartum indicates that risk factors may be longstanding and contribute to long-term risk of cardiovascular disease.

Some pundits have written that health insurance mandates are well beyond the constitutional authority of the federal government to tax, spend, and regulate interstate commerce. Others have picked up on these arguments and applied them to the EHR-implementation incentives under the HITECH Act as well. The bottom line is that these arguments fail, for four reasons.

There has been much discussion about the HITECH Act and the effects it will have on healthcare in this country. The health IT industry and the federal government claim that EHR use will lead to a decrease in costs and an overall improvement in patient care. Skeptics like me disagree with these claims and feel that the push to adopt complex EHRs will be a bad deal for physicians.

Lately, I've been thinking about how fast everything moves these days. This is true in technology, medicine, business, and other important areas of our lives. Keeping up with changes in healthcare is a real challenge; just reading monthly print medical journals won't cut it anymore in the digital age. Now, practically every day I find myself looking something up on Wikipedia.

According to results from the National Institutes of Health Bypass Angioplasty Revascularization Investigation in Type 2 Diabetes (BARI 2D) study, many patients with diabetes and heart disease may achieve better results with drug therapy instead of angioplasty.

As I wrote in a previous blog post, the approaching fire storm over the patient-centered medical home model reminds me of the destructive powers seen before in HMOs.

University of Pennsylvania School of Medicine researchers have identified cells in the atria of the heart and pulmonary veins of humans and mice that may be a possible cause of atrial fibrillation.

Results from the Oregon Sudden Unexpected Death Study indicate that women who suffer sudden cardiac arrest are significantly less likely than men to exhibit common symptoms and have an established diagnosis of coronary artery disease.

A study from Johns Hopkins has found that "routine prescription of extended-release niacin, a B vitamin (1,500 milligrams daily), in combination with traditional cholesterol-lowering therapy offers no extra benefit in correcting arterial narrowing and diminishing plaque buildup in seniors who already have coronary artery disease."

Collaboration is important in healthcare, as evidenced by the growing number of "learning communities" and grassroots efforts that are bringing people and organizations together to work on the issue of eliminating disparities in health and healthcare.

The American College of Sports Medicine (ACSM) recently updated its guidelines on fluid intake for runners during a race, citing new research on hyponatremia from the University of South Africa in Capetown.

As of December 2000, 21 of 30 randomized, placebo-controlled trials had been completed and the risk of a cardiovascular thromboembolic adverse event or death was greater among subjects assigned to the rofecoxib group, raising concerns from a safety standpoint.

A national health information technology infrastructure (NHITI) is not only necessary, but it is cardinal to improving delivery and reducing costs of healthcare in the United States.

The powerful vendor-lobbying group, HIMSS, has been extremely successful over the last 8 years lobbying our elected political leaders about HIT.

In his July 2009 editorial, Dr. Robert C. Like, MD, MS, wrote about the importance of creating "communities of practice" and the increasing role of the Web and collaboration in facilitating the development of learning networks. Here, he continues this discussion by sharing some perspectives from the field of library science about the impact of the Internet on clinical practice and public health.

The challenge of eliminating disparities in clinical trials is being addressed by the Eliminating Disparities in Clinical Trials (EDICT) project, which recognizes that broadening diversity in clinical trials will result in improved effectiveness and safety of future medicines, improved trial quality, and reduced discrepancies in health equity.

Here are the results from three presentations on the use of computed tomography and other advanced cardiac imaging in angina and chest pain at the American Heart Association Scientific Sessions 2009.