Little things you can do to reduce medication errors in hospitals

According to Institute of Medicine, an estimated 400,000 medication errors harm hospital patients.

How PassportMD can help to Prevent medication errors and other things you can do to help prevent medication errors:
1. Create and bring a personal health record with you upon admission. PassportMD offers a free service to create your record in minutes.
2. Tell your doctors the medicines, vitamins and supplements that you take to avoid negative interactions. (Or just give him the page from your PassportMD health record that you printed off for free from your computer.)
3. Ask about the drug's purpose and side effects when the doctor prescribes it. Get instructions for taking drugs after you go home.
4. Check the label of IV drug before it is given (or ask a friend or family to do that).
5. Find out how long it should drip before running out.
6. Speak up if you think you are getting the wrong drug, dosage or drip speed.

Many of these tips were generated from the Sun Sentinel Help Team at http://www.sun-sentinel.com/helpteam

Nail Salon Safety

There was a recent article in Sun Sentinel ( http://www.sun-sentinel.com/business/local/sfl-hlpnails21jan21,0,3907127.story ) found dozens of South Florida nail salons have been cited during the past three years for failing to maintain health and saftey standards.

To find out if your local salon has been cited, visit Sun-Sentinel.com/nails.

There have been over 4000 complaints lodged against south Florida nail salons and over 150 citations issued since 2003.

Infections in the nail plate, called paronychia, can be caused by either bacteria or fungus. Fungal infections of the nail plate is called onychomycosis and is very common but also very difficult to treat and can result in destruction of the nail plate. There are topical and oral treatments for onychomycosis and you can ask your dermatologist about this if you have it.

Travel Mom

I just happened upon http://www.thetravelmom.com and believe this is a great reference and resource for family travel, particularly travelling with children. You may contact her with questions and emails.

2007 Healthy Resolution tips

A recent article in AAA magazine,http://www.aaagoingplaces.com/wcny/pagesjf07/dept_livinghealthy_jf07.html#steps ,
listed 10 steps to a healthier you in 2007

1. Maintain a healthy weight.
2. Make better food choices.
3. Stay active
4. Do not use tobacco.
5. Stay Current with recommended health screens
a. women-pelvic and pap smear, periodic self breast exams, every year starting at age 18
b. women-mammograms every 2-3 years after age 30
c.men-psa at age 40 for african americans and pasa at age 50 for white men, annually
d. men and women-colonoscopy every 10 years starting at age 50
6. Mainatin an ideal choleterol level, under 200, with HDL over 45, LDL under 100, and triglyceride under 150
7. Maintain normal blood sugar levels
8. Wear a seatbelt
9. Nurture yourself, take your time to relax and go to spa, enjoy the arts
10. Manage stress and avoid bad relationships.

As a Patient , do you need help with healthcare or prescriptions

Resources are available to help patients offset the rising costs of prescriptions and medical care.. here is a short list..

PhRMA (Pharmaceutical Research and Manufacturers of America)
The partnership for Prescription assistance , visit http://www.pparx.org/

PassportMD Drug Discount Card. Save up to 75 % on FDA approved medications. There is no charge for this service, it is free and you can personalize your discount card. It is good at over 56,000 pharmacies. go to http://www.passportmdrxcard.com/ for a free drug discount card from PassportMD.com.

Rx Hope
This is a searchable database of patient assistance programs based on multiple search criteria, such as medication name, company name and state of residency..visit http://www.rxhope.com

Volunteers in Healthcare
Rx Assist
This is a searchable database of industry sponsored patient assistance programs.Go to http://www.rxassist.org/

Needy Meds
A non profit organization that helps people who cannot afford medicine or health care costs. Go to http://www.needymeds.com/

State Prescription drug assistance for seniors
A listing of state sponsored prescription assistance programs Go to www.medicarerights.org/medicarebasicsframeset.html

http://www.scienceblog.com/community/older/archives/K/4/pub4257.html

An Active Mind Might Slow Dementia

In a recent article in the Sun Sentinel by Bob LaMendola http://www.s-r.com/news/bylines.asp?bylinename=Bob%20Lamendola, he writes about a recent JAMA published study that the effects of brain exercise strengthens the ability of seniors to think more clearly and continue to live independently. This is the first sudy to link brain training to practical imporvemen indaily life. The author of the article Michael Marsiske from University of Florida suggested that seniors can “challenge yourself to learn things that are difficult for you”

Tips to challenge the mind:
learn new activities and skills
try a new hobby
learn to use a computer
learn to use a digital camera
Exercise the brain with games such as crossword puzzles, sodoku or find a word games.

700,000 People visited Emergency rooms this year due to Drug Reactions

According to a recent article in Dermatology Times,

Seniors accounted for one quarter of adverse drug events and for more than half of those that required hospitalizations.

A recent study in the Journal of American Medical Association (JAMA 2006;296:1858-66) also found that most adverse druge events were due to unintentional overdoses from a small set of medications that typically require monitoring. These include warfarin (coumadin), insulin, digoixin and these three accounted for one third of all adverse drug events in this population of people.

The five most common adverse durge classes were:
1. Insulins
2. opoiod containing analgesics
3. anti-coagulants
4. agents containing amoxicillin
5. anti-histamines and cold remedies


The most common conditions associated with drug reactions prompting Emergency Department visits:
1. dermatologic conditions
2. gastrointestinal problems
3. neurologic conditions

One third of adverse drug reactions are allergic reactions.

Interesting fact:
Sixteen of 18 drugs that caused adverse drug events have been in use for over 20 years.

What google thinks about personal health records

Google’s unhealthy medical plan by ZDNet's Donna Bogatin -- Google audacity never ceases to amaze. What is the great Googleplex conjuring up now? Google is on a medical mission, but it is an unhealthy one. Google wants to create nothing less than individual, dedicated, online databases, to record and store every piece of private and personal data pertaining to “every single medical and health-related event” for [...]

Identity Theft , a real issue

Did you know that identity theft was estimated at 9-10 million cases per year for the last 2 years? Millions of Americans each year are victims costing an estimated 50 billion dollars.

Is it tied to Social Security numbers? Probably, but lets take a look at this. Social security numbers wer initially issued in the thirties for the purpose of administering social security programs. However, today, this is not the case. These numbers are being used for everything from medical records to bank accounts to employee record keeping.

Thieves steal social security numbers. How?

They do this by physical theft of purses, searches through trash, and when consumers provide personal information to an unsecured internet site.

So, according to Andrew Ellis' article, "Here's how to avoid ID theft.." published in the http://www.concordmonitor.com ....there are some simple steps to minimize the risks..

1. shredding paper documents that many contain sensitive info
2. dont' carry social security card in wallet, store in a safe place
3. shred credit card solicitations
4. shred unneeded old personal tax info.
5. If any company or business requests your social security number, think twice and ask ..why? and how will it be used? and how do you protect it from being stolen?

An emerging sector of theft is medical id theft. People stealing a person's medical id info and using their benefits from their insurance to make money. Sites like our http://www.PassportMD.com help individuals keep better control of this information and watch if it has been used for other purposes. One advantage of http://www.PassportMD.com is that this personal health record site, does not require or ask for any social security numbers and is is secure. Both are compelling reasons to use our site to monitor and control your health information without having to enter your social security number.

There are a number of informative sites and blogs on this topic...
1. http://www.schneier.com/blog/archives/2005/04/mitigating_iden.html
2. http://www.identityblog.com/
3.http://blog.trustedid.com/
4. http://www.businessweek.com/the_thread/techbeat/archives/2006/05/identity_theft.html
5. http://flyinghamster.com/post/29146

Long Term Care , When should I be thinking about it?

It is never too early to start thinking about long term care. All of us are susceptible, none of us immune to the unpredictable. Life goes by , at a fast pace, it is easy to compartamentalize these issues and concerns into our "denial" portion of our brain. Who really wants to think about being debilitated and needing long term care? I dont.

But, as with everything in life, preparation is 99% of the battle. We think about retirement, we put aside money in our 401K's, retirement accounts, and even "under the mattress". But, what makes the most sense?

Studies have shown that Americans rank long term care second, behind saving for retirement, when prioritizing financial needs.

Let's define Long Term Care: According to the following web site
http://www.rmminc.net/

Long term care includes a range of nursing, social, and rehabilitative services for people who need ongoing assistance. Most people in long term care facilities are older, but many young people need long term care during an extended illness or after an accident.Assistance with routine personal needs such as bathing, dressing, eating, toileting, and taking medicine is the most common long term care service. Long term care facilities also provide skilled nursing and rehabilitative care, which is ordered by a physician and supervised by skilled medical personnel such as a nurse or licensed therapist.

In a recent article by Mary Saunders, she gives the following tips to people thinking about long term care insurance:


1. Talk to your financial planner or insurance agent about whether long term care insurance makes sense for you.
2. Ask your financial advisor to recommend a company and a policy.
3. Check with insurance rating services to make sure the insurance company you are considering is financially secure.
4. Call your state insurance department (In NY for example, http://www.ins.state.ny.us/cseniors.htm and ask about the company and its record in your state.
5. Make sure your insurance agent is licensed to sell long term care insurance in your state.
6. Review all the details and options of the policy. Do not rely just on the marketing materials or outline of coverage.
7. Make sure you understand all the provisions before you purchase any policy.
8. Ask your insurance agent questions. Seek guidance from the state insurance commission office, the Area Agency on Aging, or local senior centers. Discuss policies with friends, family, and others whose opinions you respect. Take time when choosing a policy, and don't allow yourself to be pressured into making quick decisions. And remember: Never pay cash.


When Is the Best Time To Buy Long Term Care Insurance?

Because long term care insurance premiums are based on age at the time of purchase, the younger you are when you purchase a policy, the less expensive the annual premium. These premiums for most policies stay level each year as you age. If you buy at age 55 a policy that cost $800 per year, you will continue to pay the same premium. However, if you wait until you are 65, the same policy will cost you $1,700 per year.

GoodMedicare.com and How to Get it For the Elderly

Some people "talk the talk" and some "walk the walk", I have just recently met "online" , Jeanne Hannah, an attorney from Michigan who has committed herself to helping people find good medical care , particularly for the elderly. She "talks the talk and walks the walk" and has a book to prove it. I highly recommend the book, "Taking Charge: Good Medical Care for the Elderly and How to Get it", this can be found at the following link http://goodmedicalcare.com/ .

Why is this important. Well, nothing really speaks to our audience like this. It is exactly what we need for our parents and grandparents. The escalating health care crisis has impacted everyone and not only in the wallet. Quality of life and quality of health care are 2 parameters that need to be measured qualitatively when determining our life experiences with our care givers.

If you have ever experienced an illness, sickness or debilitation, then you know what it's like to be a patient. Until you become a patient, and feel that vulnerability , and dependence on a fractured system, you really dont know the feeling of helplessness. Helplessness is just a concept, I believe it can be over come with education, information and control. Education and information will help you understand that you do have choices and options in the healthcare world. Education and information can be found in Hannah's book, http://goodmedicalcare.com/
.

Control starts with knowing what your problem list is.. knowing your medications...and having the "control" to take those problems wherever you need to go for medical help. This starts with programs like PassportMD's Free personal health record. We have committed our team to creating a resource, such as can be found at http://www.KeepSeniorsHealthy.com that utilizes unique software created by PassportMD to offer this free resource.

So, take control. Read Hannah's book. Create your own personal health record. Understand your choices and options.

Facts about Personal health records

A Harris interactive poll found that 42 percent of adults maintained some sort of personal or family records. But, only 13 % did so electronically.

The biggest concerns are privacy and accuracy and these issues are deterring adoption.

http://www.KeepSeniorsHealthy.com and http://www.PassportMD.com are two sites that we have created for FREE service so that people will begin to adopt personal health records. We emphasize security and protection. We do not ask for social security numbers and adhere to the strict guidelines of the BBB privacy Seal.

Other companies that offer similar services are http://www.medicalert.com and http://www.capmed.com .

Here is a list of findings from the Harris Interactive Poll..

Of the people that keep a record of their health:
68 % keep it in a drawer
15 % in a formal health record book
13 % in an electronic health record

the biggest concerns by patients' regarding personal health records are:
Privacy 68%
Security 66%
Errors in records 37%
Wont be accessible in times of emergency 37%
Cant keep it up to date 33 %
Info from doctors wont be accurate 29%
Inability to transfer records 26%
Inability to understand items 20%
other 5%

Other blogs that contain some great health information are:

http://www.thehealthcareblog.com/

http://blog.thirdage.com/?p=613

http://www.highlandpdx.com/blog/?cat=12

http://blog.lib.umn.edu/schwitz/healthnews/2005_02.html

what does it mean that my doctor doesnt have Electronic Medical Records? Is he behind the curve?

Most doctors do not have electronic medical records , called or referred to as EMR's. However, the trend is changing and doctors really should go electronic. It simply is better medicine. Today, only 15 % of doctors have EMR's in place. This is a very low number and represents a low adoption rate. I incorporated an EMR into my practice several years ago, and it has improved efficiencies and allowed all of our doctors to practice better medicine.

Doctors are reluctant to "go electronic" given the cost burdens and technology obstacles , so until this minimizes , adoption will be slow. However, it is a better way to practice medicine , it is better for the physician and better for the patient. Eventually all practices will go electronic, but this may still be a decade away. Doctors should be financially incentivized to adopt EMR's to minimize the barrier to adoption.

According to a recent article in http://www.healthleadersmedia.com there are several myths that doctors need to "debunk" before adopting EMR's.
1. All EMR's are alike. This simply is not true. Some systems are more template oriented, http://www.medinotes.com and some are more elegant document management solutions, so called hybrid systems, such as http://www.srssoft.com/ . Others are more comprehensive such as NextGen. A issue to consider is data compatibility and the recent EMR certification commission for Healthcare Information Technology. Certification should only figure in on a small level ..as there are many great companies, like medinotes and SRS that have not yet received the certification. Certification to many companies may be cost prohibitive so physicians should not let this totally sway them.

2. EMR's are a fad. Emr's are not going away so physicians will eventually need to come to grips with this.

3. The technology is the hard part. Actually the hard part is adapting work flows to the technology, rather than the technology itself. Bigger groups can retain a dedicated technology position to maintain their systems, this will need to be outsourced for smaller groups.

4. The software is the expensive part. This is not true. The big cost are maintanence, licenses, technology support and hardware.

5. Computers interfere with patient relationships. This is not true either my patients really appreciate that my practice has computers in each room. They embrace this rather than object to it. There is a sense of comfort for the patient knowing that their physician has taken the time and effort to continue to advance their medical practice.

Would you want to speak to your doctor via email?

Would you rather get an email from your doctor or a phone call?

It might not matter what you want , currently doctors are slow to adopt email as a form of communication with patients.

For instance, in 2000-2001, 1 in 5 doctors were using email with their patients, today 6 years later that has only moved to 1 in 4 doctors.

There may be many reasons for this slow adoption

1. lack of reimbursement for their time to write or consult via email. (although docs really dont get anything for speaking with patients by phone).
2. Liability. I think a big hurdle is docs concern over putting what they think or advise in an email that, if incorrect advice, may come back to haunt them over a malpractice allegation. This is, in my opinion, the single biggest hurdle.
3. Difficulty with rendering a true opinion via email. Another reason may be that it is difficult for a doc to render an opinion without seeing or actually "hearing" their patient explain their problems. Email , currently, may be inadequate to provide enough of a picture for the doc to feel comfortable rendering advice or an opinion.

what are your thoughts ? Are you ready for an email consultation

Are you really ready to retire? You may need more than you think

If you think you are ready to retire, make sure you have done the math...

According to a recent article in Medical Economics, there are many "risks" or "factors" that need to be considered carefully...

here is a list of them to double check:

1. Inflation. Inflation is at 3.8% but could go up to 5%. So, for example, if you plan to retire 10 years from now, $2 million dollars would only be worth 1.35 million or better said, the lifestyle that you have anticipated costing $120,000 would really cost $177, 000.

2. Taxes. The $120,000 you are planning to withdraw annually from tax deferred account will resul in $23,000 tax bill in todays tax scenario.

3. Timing. This is potentially the most devastating. If your retirement in in funds and stocks and the market drops when you retire, then your nest egg will drop too, for instances if the market loses 20% of it's value, your $2 million will drop to $1.6 million.

Here are some sites you can visit for more info:
http://personal.fidelity.com/retirement/retirement_frame.shtml.cvsr

http://www.aarp.org



3. Timing.

Seniors be weary of "Free" Advice for placement in Assisted Living Centers

Children of aging parents often live a distance from their parents. As a result, either the children or the parents come to rely upon "Placement Services" as it relates to assisted living centers.

These placement services often receive a fee for each new resident that they recruit to a particular living facility. Thus, they are biased.

You can get objective and detailed guidance from the Assisted Living Federation of America http://www.alfa.org or the Nation Center for Assisted Living http://www.ncal.org

If you really need more help, think about hiring a geriatric care manager such as a nurse, social roker, or counselor. They may be expensive but worth it.

Geriatric Care Managers can be searched at http://www.caremanager.org

Other blogs that contain some great health info are:

http://blog.hcfama.org/?p=65

http://www.tabinc.org/blog/archives/2004/11/index.html

http://www.thehealthcareblog.com/the_health_care_blog/2006/09/the_choice_a_lo.html

http://www.thehealthcareblog.com/
http://blog.thirdage.com/?p=613

Lung Cancer, A Killer that doesnt give early warning

Lung cancer is a problem. Currently with a cure rate of less than 20% , we need to find early markers of the cancer. This is critical and continues to be a problem.

According to the http://www.cancer.org/docroot/home/index.asp American Cancer Society here are some fast facts about lung cancer:
1. New cases - 174,470 each year
2. Deaths in US 162, 460
3.Men: 92,700 New cases, 90,330 deaths
4. Women 81,770 new cases, 72,130 deaths
5. 44.5 million American Adults smoke

go to : http://www.lungcancer.org/ to learn more about Lung Cancer.

What is on the horizon? According to Dr. Mark Block, a thoracic surgeon in Hollywood Florida, more advances are being made. In a recent article in Florida Trend Magazine, he cites the following promising advances:

1. Chantix http://www.chantix.com/ a new drug designed to help smokers quit cigarettes by blocking nicotines effects. The FDA fast tracked this drug's approval.


2. Vidao assisted thoracic surgery- minimally invasive surgery that allows docs to view inside of chest through small incisions, ideal for biopsies.

3. Endoscopic ultrasound guided fine needle aspiration- helps sample lymph nodes

4. Lung volume reduction surgery- helps patients that were previously unable to have lung cancer surgery due to diseased lungs with poor lung function.

5. CT scans- great screening test for lung cancer

6. New drugs such as Tarceva http://www.tarceva.com/tarceva/patient/index.jsp?hl=en&lr=&q=tarceva


if you have any other comments on lung cancer please post them here...

Chicken soup or Zinc, which fights colds better?

Who is right: Grandma or Science?

Well, according to a recent article in Health Magazine, Dr. Prasad at Wayne State University, has done research which shows that you will catch fewer colds by taking 45 milligrams of "elelmental zinc". He goes further to say that if you feel a cold coming, you can get over it in half the time by taking zinc acetate lozenges every 3 -4hours.

The website, http://www.coldcure.com/ talks about this even more...

Bad news for Chicken soup, but, good news is ..no one has looked at wonton or hot and spicy yet.

Foods thatTrigger heartburn

According to a recent article in Health Magazine, http://www.health.com/health/
here is a list of the top 9 foods that cause indigestion and heartburn:

1. Alcohol
2. Chocoloate
3. Coffee
4. Garlic
5.Citrus fruits and Juices
6. Peppermint
7. Tomatoes and tomato sauce
8. Peppers (all types)
9. Onions

So, no complaining when you order a late night munchie , large Domino's pizza ( http://www.dominos.com/ ) , with onions, peppers and sausage and pepperoni. (And dont think that because sausage and pepperoni is not listed above, that you will be okay with that)

Popular herbal remedies may be riskier than you think

Here is a list of popular herbal remedies you might find at a natural health store...I will list them and their potential effects:

1. Garlic- lowers antiplatelet and LDL cholesterol. Also, may cause adverse effects if taken by patients on anticoagulants.
2. Ginkgo biloba- can increase anti coagulation. May cause adverse effectsin patients predisposed to seizures.
3. Green tea-popular for it's anti oxidant properties. But, it can affect the absorption of asthma mediations and stimulatns such as pseudophedrine and atropine. It may also increase blood pressure.
4. St. John's wort- used to treat mild depression. But, it may adversely interact with MAO inhibitors and anti depressants or it may sped the absorption of other drugs such as chemotherapy.
5. Valerian- used to treat insomina but may heighten the effects of prescription medications used for insomnia or anxiety. Can also cause a paradoxical reaction.

So, be careful and check with your doctor before taking these remedies...