Shout Outs

Updated 3/2017-- photos and all links (except to my own posts) removed as many are no longer active and it was easier than checking each one.

The Schwartz Center is the host for this week’s  Grand Rounds.  You can read this week’s edition here (photo credit).

Welcome!

The theme of this week’s Grand Rounds is hot topics in healthcare communication. Since this is also the last issue of summer, I’m including photos from my summer vacation to Yellowstone National Park, a hotbed of geothermal activity. (Just for fun see if you can identify Yellowstone’s mascot, the American bison, hidden in one of the photos.)

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Dr Charles has announced the winner of The Charles Prize for Poetry, 2010.  There were over 125 poems entered.   I hope you will head over and read them.  Congratulations to the winners!

Winner:
Fireflies, by a medical resident
Runner Up:
Song for my Father, II, by Pal MD
Honorable Mentions:
TO SYLVIA, by Maria A. Basile, M.D.
The Harvest, by C.L. Wilson
If I Were Frida Kahlo, by Amanda Hempel

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Dr. Val, Better Health,  announced on twitter yesterday:

@drval Save the date: @kevinmd @doc_rob @drval live coverage of ADHD awareness on Ustream Thurs, (9.16.10) 12-2 ET. http://bit.ly/d4G67t

Hope you will join the group if you happen to be available.  The event is coverage of this forum:

Fact or Fiction: ADHD in America, A Capitol Hill Forum
Rayburn House Office Building Room B-338
Washington, District of Columbia
United States

To coincide with ADD/ADHD Awareness Week, join us for "Fact or Fiction: ADHD in America, a Capitol Hill Forum," a lunch and panel discussion which will dispel myths and shed light on the diagnosis, treatment and management of ADD/ADHD in people's everyday lives.

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ReachMD has a really nice audio program full of the history of prosthetic heart valves:   The 50th Anniversary of the First Prosthetic Heart Valve: 1960 to Today

On the 50th anniversary of the first successful prosthetic mitral valve replacement, how far has cardiac surgery come, and where are we headed? Tune in to hear Dr. Albert Starr, co-founder of the first artificial mitral valve,……, recounts his first foray into the field of valvular disease and the extraordinary process of inventing the first artificial mitral valve. …… What does Dr. Starr see as the "next big thing" in cardiac surgery? Dr. Janet Wright hosts.

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Perhaps I need to try designing a new hospital gown.  Not sure anyone would pay attention to my ideas as Cleveland Clinic has to Diane Von Furstenberg.  Apparently the Clinic has been working with the designer for three years and is now ready to try out the newly designed gown (photo credit)

  A possible issue I see with the gowns is the lack of snaps along the top of the sleeves.  Snaps along that shoulder seam make it easier to place the gown on patients with limited shoulder motion or large upper extremity casts/dressings.  It also makes the gown easier to remove/replace on patients in the OR.

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I love this!  It was shared by Jill of All Trades, MD in her post “Stray Cat”

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Dr Anonymous guest this week is Radio Rounds.   The show begins at 9 pm EST.

Upcoming shows:      
9/18: Saturday Nite
9/23: Follow-up school name change & value of alumni
9/30: EMS Newbie Podcast
10/7: Dana Lewis        

Don’t Forget HIPAA Privacy Rules

 Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

As we move towards EMR’s, the ability to know who has looked at the medical record may get more and more in trouble. While we are all curious about our friends, neighbors, and celebrities (local or global), it is important to respect each others privacy. This local Arkansas story (3/2017-- link no longer active) shows the importance of this respect.

Hospital emergency room coordinator Candida Griffin, patient account representative Sarah Elizabeth Miller and Dr. Jay Holland, a family doctor who worked part time at the hospital, each face up to a year in prison and $50,000 fine if convicted of the misdemeanor charge.

I would hope that all three of the people listed above would have “known better.” When this story broke earlier this week, the staff in the OR and I had a nice discussion on who gets HIPAA training and how much each get.

I think as part of their punishment, they and perhaps the facility (St Vincent Health System) should have to do refresher courses on HIPAA privacy rules.

The hospital said in November that it fired up to six people for looking at Pressly's records after a routine patient-privacy audit showed that as many as eight people gained access to them.

It was not immediately clear whether others fired from the hospital would face charges. U.S. Attorney Jane Duke declined to comment about the charges Tuesday.

With paper charts, there isn’t a trail proving you or I accessed the chart without need to do so. With EMR’s there is but this trail is not fool-proof. If I haven’t logged off and you look over my shoulder, then ….

If you haven’t logged off and I ask for a quick look at patient 007’s lab work and you do me a “favor” of checking quickly. See, not perfect. No harm was intended and patient 007’s info may never be “leaked” to the press, but someone who perhaps had no need to access it did so.

My circulating nurse in the OR during the discussion revealed that she had heard a lot of talk about the Ann Pressley case which she admits she should not have. She didn’t access the chart. She was working in another hospital’s ER. It was the police and EMT’s doing the talking. There is no trail to “prove” those violations of patient privacy trust.

We need to be more careful in discussing patients and cases. We still need to be able to discuss difficult or unusual cases, but this can be done without breaking a patient’s trust or privacy. Names and identifiers don’t have to be used when stumped by a rash or odd presentation.

Dr Holland had no malicious intent, just curiosity. Be careful.

Arkansas Democrat Gazette article Doctor, ex-hospital employees charged over Pressly records (subscription required) written by Linda Satter

3 charged with getting TV anchor's medical records by Jon Gambrell (no subscription required)

Local Hospital Discontinues Eye Surgery Service

 Updated 3/2017-- all links (except to my own posts) removed as many no longer active. and it was easier than checking each one.

I received my April issue of the St Vincent Health System Communiqué in Monday’s mail.  I was surprised to see this:

Eye Surgery to Close

Effective April 1, 2009 St Vincent will no longer offer surgical eye services at either Doctors or the Infirmary.  This difficult decision came after a long discernment process weighing the pros and cons of closing a service St Vincent has had for decades.  Unfortunately, shutting down the service is a sign of the times as volume has slowly decreased and many other more cost effective alternatives exist for patients and physicians alike.  Patients presenting to the hospital needing surgical intervention will need to be transferred to UAMS or Baptist Medical Center, the two remaining hospitals to offer surgical eye services.

I had missed this story earlier in March in the Arkansas Business News.  

St. Vincent will cut open positions first and then layoff workers who aren't tied to patient care, said Peter Banko, the CEO of St. Vincent.

St. Vincent Infirmary Medical Center also announced it will close its psychiatric unit for older patients, its Medicare-exempt psychiatric program and eye-surgery program by April 1.

Banko said he tries to keep up the morale of the system's 3,000 workers by keeping them informed through e-mail updates and his blog.

And here it is again on Arkansas Blog (March 24, 2009) – St Vincent Plans Job Cuts.  I have been aware of the job cuts, but had missed the surgical services cut.  And for the life of me, I have been unable to find Mr. Banko’s blog.

Other relates blog posts
Update on the Economy and its effect on BIDMC – Paul Levy, March 6, 2009
Final Budget Decisions  -- Paul Levy, March 24, 2009
How Bad is it for Hospitals?  -- Dr Wes, March 26, 2009
Desperate Hospitals Update – Medical Quack, April 12, 2009