"Forgot About Pluto"

This is a song that my sister had to write for her education class, I think it's hilarious. 

The amazing thing is that, my friend mike (@gamerjunkdotnet on twitter) wrote the song in less than an hour, the only instructions he had were: 

1) A rap about pluto

2) to the beat of "Forgot about Dre"

Thanks Mike for all your help.

If you are interested in the lyrics:

"FORGOT ABOUT PLUTO"

Ya'll know pluto, 
The same distant planet from the sun
Until group of scientist won
the right to say it wasn't one

Its moon was outraged 
and its name: Triton

Declassified as a planet 
like it couldn't handle it
In theory, dismantled it and 
abandoned it, Can you handle it?

(Chorus) 
Now a day's everybody will forget
Everything' hard to get
Scientist act so frugal 
Walking back and forth saying: Bye, Adieu, and Tootles
So so sad that they forgot about pluto


All these changes were made
Now we say "plutoed" 
for the way you were played
Even Galielo would hold it near and dear
Pluto we know you still here

Dwarf planet with your fellow peers
Smaller than Earths moon, 
between the sun and Neptune
A planet misunderstood, 
Scientists just changed their tune

Dwarf planet in the kuiper belt
Some scientists felt, 
this wasn't right, looked up at the starts looked passed your way 
Thats why we say

(Chorus)

Adding a Personal Touch to Health Care.

Computers have allowed us to extend our physicians and allied care providers further than we have ever imagined. In the near future a specialist in New York will be able to perform minor surgeries with the aid of a broadband connection and a robot. We have already started to move towards portability in medical records, we have faxed prescriptions for years and have very explicit rules about "Calling in a script". With each one of these advancements we experience the convinience of having faster results, second opinions and even "Long-Distance-Consults", but are we losing a personal touch?

I read an article in the New York Times, about a young resident in Jerusalem who was tired of not being able to put a "Face" to the X-rays he was analysing, his father had the brilliant idea of adding a picture of the patient to the film being diagnosed. An actual picture of the patient. In turn he noticed that he started to pay more attention to the details in the x-rays; he talked to his colleagues and they too found that putting a face to the "file" actually made them care about the patient. 

We have to remember that many Health Care Professionals like pathologists, radiologists and pharmacists don't really get much patient contact, and in theory we could "outsource" all medical jobs with the exception of nurses, since they need to be bedside to care for the patient. And although having long distance consults has greatly benefited rural communities, and telecommunication has allowed us to put professionals within reach of otherwise unreachable patients, it has affected the personal touch that "Care" is entitled to have. Radiologists, Pathologists and Pharmacists usually work isolated from their colleagues many times in separate wings of hospitals. In short we need to give this Health Professionals the satisfaction of knowing who they are helping.

We've all heard the adage "You can make a difference", Dr Yehonatan N. Turner actually did make a difference.  He wants to add a personal touch to Health Care. His idea is being tested in Chicago. And one day, after the bracelet is attached to the patient's wrist, we'll take a snapshot of the patient with an inexpensive digital camera. That way, we can actually know the patient we are treating. This could have many benefits, less patient confusion, if an error was made we could remember the patient -even months after the error occurred- and most importantly we can relate to the actual person we are helping.

 

The New York Times

Radiologist Adds A Human Touch

by: Dina Kraft

April 6th, 2009

Digital Medical Records.

As I have learned in my classes our industry is moving towards the digital  management of patient records. This in concept is a good trend, and President Obama's  stimulus allocates approximately nineteen billion dollars for the implementation of such systems in hospitals across the US. 

A recent story in the New York Times looks at two articles that will be published in the near future; these two articles point to the obstacles that our Health Care System will face in trying to implement digital medical records. These articles show that only about 9% of hospitals in the US have electronic medical records, and even those hospitals that do use electronic records, do not necessarily share the medical information with primary physicians or other hospitals. 

It is important to note that the power of electronic records lies in the portability of these records. In other words, that a patient that has been discharged from a hip replacement surgery can have his or her records "beamed" to their long-term care facility, that way that person's primary care team can be in synch with the continuum of care of the patient. More communication between providers, less mistakes.

Communication is not happening, hospitals with electronic records are not able to communicate with other providers for different reasons, for example, the other providers cannot access e-records, there is no uniform "language" for electronic records, or simply physicians with older practices do not want to change.

 

It is of importance to note that the Obama administration will be awarding around $40,000 per doctor and millions to hospitals who adopt electronic records (with one condition, they have to be certified as adopting the technology for "meaningful use"). Still, we will see a rapid growth in this industry. As the future of this industry, we need to assure that this change is not merely a trend, but a positive step towards safer, more cost effective health care. 

How will we take this step is the first question we need to ask ourselves. Then a flurry of questions begin to follow, for example, 

What is meaningful use?

Who will have access to the records?

Should we commission one company to develop a standardized system, or should we use an open source approach?

The time will come when we will need to come together and have concrete answers to these questions, meanwhile, we can appreciate how throwing money at a problem is not the most efficient way to fix it. 

--------------------------------------------------------

The New York Times, March 25th, 2009 

"Doctors Raise Doubt on Digital Health Data"

By: Steve Lohr

LTC Insurance

For my LTC "Wild Card Blog", I decided to type long term care on google and see what the results would be. To my surprise, after scrolling down the literally millions of results from my query, I kept stumbling on article upon article on LTC insurance.

I personally thought that I would read about the horrors of LTC, about abused customers, enraged family members and the dangers of unkept facilities. Instead, I came across long guides on how to select the proper insurance from AARP, essays from the NY Times on how to avoid overpaying for insurance and trim the "fat" from costly insurance programs, and stories about elderly patients that after years of paying premiums in a timely matter are denied simple care that costs pennies on the dollar.

What is LTC insurance (LTC-i)?

LTC-i is a safety net to avoid the unprecedented costs of the long term care needed in our later years, this type of insurance started in the early 70's and was initially popular with wealthy individuals who were aware on the steep incline of medical services in the United States. Premiums floated around $7,000 a year, and they did not include services such as home modification (adding rails to bath tubs, replacing door knobs to door handles) or extended hospice stay. A standard medium range LTC insurance costs about $1,600 and it offers many services not covered by MediCare, such as home help with ADL's, Adult Day Care, and home nursing.

Still, many Baby-boomers are reluctant to buy LTC-i, they are afraid that like their parents, many services will not be covered and their money will go to waste. Although we cannot for see what the future standards of care will be, organizations like AARP and other elderly advocacy groups have fought to regulate LTC-i practices.

In short, aging gracefully is turning more into an art than a right. As consumers we need to inform ourselves and take care of our elderly population as new and more advanced systems of healthcare are being developed, and although these systems will help us live longer healthier lives, we need to have the resources to finance them. LTC-i is one of the many ways to finance our care. Although not perfect, and for many still a luxury, LTC-i is a necessary evil to those privileged enough to know about the importance of a plan for our golden years.

Finally, I will give you a couple of suggestions AARP recommends to look for in LTC-i:

Coverage: A coverage that is appropriate for your style of living is the most important part of your policy. Coverage can include a home nurse, hospice stay, alternative care, adult day care etc. The costs that exceed your coverage, or that are not covered are the responsibility of the patient.

Daily or Monthly Benefits: Benefits are usually payed in either of the formats and the insurance company divide the amount it pays to the Health Facility according to daily or monthly use. Once again if care exceeds any of the time frames the patient pays the balance.

Benefit Period: This is the span that your coverage will last. Your can choose to cover for a predetermined amount of time or for the entirety of your life.

Waiting Period: This is the period before your insurance kicks in. It can last from a couple of months to no waiting period. The shorter the waiting period, the more pricey the insurance policy will be. During the waiting period, the patient is responsible for payment.

Inflation Protection: This is simply to assure you that you will pay for future treatment at current prices.

Non-Forfeiture of Benefit: This can add a lot of cost to your policy, but it protects patients from cancellation of benefits from lack of pay.

(Source AARP)

Citation:

Long Term Care Insurance. (2007). Retrieved January 23, 2009 from AARP, AARP.org: http://www.aarp.org/​money/​financial_planning/​sessionfive/​longterm_care_insurance.html.

What does Long Time Care mean to me...

Long Term Care to me is a health system designed to provide care to an individual for an extended period of time. For many skilled nursing or skilled health care has to be available for extensive periods in order for full recovery; from accident victims to palliative care. Nursing Homes, Rehabilitation Services and Hospice care immediately pop into mind.  Another aspect of Long Term Care (LTC) is the stigma that LTC carries, nursing home abuse, overworked nurses and disgruntled employees dealing with overcrowded facilities. Seldom do we think of the millions of patients that learn how to walk for a second time, or the  elderly that have no family to provide basic care or even the care (physical and spiritual) that both patients and families receive from hospice workers. 

What I know about LTC is that sooner or later someone we care for (or even us) will need to use the services of a long term care facility. For that reason we need to improve the service being provided, we need to streamline the delivery of care and we need to change the way we think about these necessary health care facilities. This semester I hope to learn more about the history, development and role these organizations have in our health care system. I also hope to learn where these organizations should be heading, that way when I am part of the United States Health System, I am able to better serve my patients.  

End of Life

I thought it was appropriate to talk about End of Life for the last blog in this Health Care Ethics class. There are many issues that we could talk about, from abortion to death with dignity. Surely in the news you have read about doctors who in the name of beneficence perform "mercy killings", patients in Oregon have the ability -after jumping through many loopholes- of requesting to end their life.

Where does the Hippocratic Oath fit? Should it be revised? Is it all encompassing? As I discuss this with my family and friends, I have heard many different arguments both in favor and against this topic. The only thing that pretty much everyone agrees on is that in the end, it should be the patient who decides. And even when the patient does not have a voice, the health care surrogate should try to represent the interests of the individual to the best of their knowledge.

Finally I want to talk about the importance of a living will. A living will is a document that lists your wishes in case you are not able to make a decision about your life. To put bluntly, it is a legal document that will serve as a your decision, in case you do not want to be resuscitated or if you do not want to be hooked up to life support if you are brain dead. It can be very detailed, and you can specify treatment that you do not want performed on you and it could also include specific instructions about organ donation. It is free and once again, to be respected by any court. I bring this up, because its important to take the burden away from your family. No one wants to be responsible for the decision of taking some one off life support, and by having this document you can take the burden away from your spouse or your parents. This holiday season, talk to your family, ask them how they feel about a tough situation like the one Terry Schiavo was in. Tell them how you feel, and you might be surprised by their res ponce. Take responsibility of your life, and if the unthinkable happens, don't leave them with that responsibility.

Florida Living Will

What role...

What role should spiritual care take in the Hospital setting?

Many hospitals are sponsored by religious institutions, the Methodist church, the Mormon church and the catholic church stand behind some of the most prestigious hospitals in the nation. Here in Orlando Florida hospital is the only hospital in the central Florida area to perform transplants and yes they are backed by a religious entity. And even though the care they provide is rooted on scientific research, what role should their spiritual care take in the Health Aid setting?

As I read article after article on how faith can be used as part of mental health, I am convinced that spiritual care can be an asset, even hospitals that are not sponsored by a religious denomination usually employ chaplains or people specialized in faith based relations. But, what are the boundaries of Faith Based Care?

In a journal entitled "Ethical Boundaries of Spiritual Care" the author outlines a couple of suggestions on what the boundaries should be, and all of them focus on the same principle, respecting the patient. This is my interpretation of those suggestions:

1.- In order to provide care, the provider should have an understanding of the patient beliefs.

Simply put, we cannot override the wishes of an autonomous person, we are responsible for educating ourselves, listen to what the patient has to say, and learn from their beliefs -even if we don't agree.

2.- Respect means following the patient wishes.

We can learn, listen and understand but if we don't follow patient wishes, we are infringing on their rights.

3.- Providers should not prescribe spiritual practices, nor urge patients to relinquish their beliefs.

We cannot undermine a patients belief system. If providers start to suggest practices, rituals or other forms of spiritual care, it will end up degrading the respect that medical care deserves. This in turn could damage the personal and professional integrity of the provider.

4.- Health Care Providers who care for the spiritual needs of patients should understand their own spirituality.

One cannot help in this very touchy subject if one is confused about our own belief system.

Ultimately, as said before, spiritual healing is an important part of wellness. But every provider should be aware of the fine line that spiritual care can pose.

Link to Journal:
Ethical Boundaries of Spiritual Care