Pain

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.

The catchphrase for rheumatoid arthritis treatment has become "early and aggressive." It is the best remedy that medicine has today for the management of RA.

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.

In "Managing Opioid-Induced Constipation in Ambulatory-Care Patients," Clyde R. Goodheart, MD, MBA, MS, and Stewart B. Leavitt, MA, PhD, note that constipation is a frequent side effect of treatment with opioid medications.

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.

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.

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.

Pain assessment appears to reduce sedative drug dosing, allowing for objective pain evaluation and analgesic drug dosing based on a patient's report.

Compared with study participants who reported no pain, those experiencing chronic pain in two or more joints had a 50 percent greater risk of falling.

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.

Breast-cancer patients who experience chemotherapy-induced peripheral neuropathy during their treatment with Taxol are three times more likely to eventually be diagnosed with chronic neuropathic pain.

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 laboratory studies, morphine can directly boost tumor-cell proliferation and inhibit the immune response. Researchers also found that opiates promote angiogenesis.

I have been following with interest all the discussions about the new Medical Home (aka, the Patient Centered Medical Home) concept. This is our silver bullet that will improve patient access, raise quality levels, increase overall satisfaction and save billions of healthcare dollars - all at the same time!

Dutch researchers confirm that five strength exercises--the one-arm row, shoulder abduction, shoulder elevation, reverse fly and upright row--can substantially reduce perceived pain.

Adults partaking in animal-assisted therapy while recovering from total-joint replacement surgery require 50 percent less pain medication than those who do not.

Findings a cause for concern as depressed patients are excluded from virtually all controlled trials of opioids as a high risk group for addiction.

In an article published in JAMA, researchers surveyed over 3,200 breast cancer survivors who are 2-3 years out from treatment were surveyed to determine how often these women experienced and continued to suffer from pain.

At PAINWeek 09, Howard Heit, MD, FACP, FASAM, began his presentation "The Patient-centered Approach to Urine Drug Testing in the Chronic Pain Patient" by briefly discussing the concept of Universal Precautions in pain medicine, noting that the term originated from the infectious disease model.

The pundits are going to have their field day with this one. "The danger [with this Bill] is that as costs continue to rise and coverage becomes less comprehensive, people will conclude that we've tried health reform and it didn't work. But the real problem will be that we didn't really try it.