The Informatics Review Vol. 6 No. 8 - Apr 15 2003 -- Current Reviews in Clinical Informatics

Google: Net Hacker Tool du Jour
The hacks are made possible by Web-enabled databases. Because database-management tools use canned templates to present data on the Web, typing specific phrases into Internet search tools often leads a user directly to those templated pages. For example, typing the phrase "Select a database to view" -- a common phrase in the FileMaker Pro database interface -- into Google recently yielded about 200 links, almost all of which led to FileMaker databases accessible online. (Are your db's safe?)

Effects of internet behavioral counseling on weight loss in adults at risk for type 2 diabetes: a randomized trial
Participants were randomized to a basic Internet (n=46) or to an Internet plus behavioral e-counseling program (n=46). Both groups received 1 face-to-face counseling session and the same core Internet programs and were instructed to submit weekly weights. Participants in e-counseling submitted calorie and exercise information and received weekly e-mail behavioral counseling and feedback from a counselor. Intent-to-treat analyses showed the behavioral e-counseling group lost more mean (SD) weight at 12 months than the basic Internet group (-4.4 [6.2] vs -2.0 [5.7] kg; P =.04), and had greater decreases in percentage of initial body weight (4.8% vs 2.2%; P =.03), body mass index (-1.6 [2.2] vs -0.8 [2.1]; P =.03), and waist circumference (-7.2 [7.5] vs -4.4 [5.7] cm; P =.05).

Using a personal digital assistant enhances gathering of patient data on an acute pain management service: a pilot study
The study physician (a PDA-user) reported feeling comfortable with the assessment software after five patient assessments. PDA assessments were more likely to contain documentation regarding pain and side effects (e.g., nausea, pruritus, hypotension) than the paper assessments. The median time of the "assessment only" component of the patient encounter was 53 sec longer using the PDA compared to paper (P < 0.00), however, the median "total encounter" (chart review, assessment, documentation) time was 74 sec shorter using the PDA vs paper (P < 0.00).

The Changing Face of Ambulatory Medicine: Reimbursing Physicians for Computer-Based Care -- ACP Analysis and Recommendations to Assure Fair Reimbursement for Physician Care Rendered Online
This paper urges the Centers for Medicare and Medicaid Services (CMS), and other insurers to take note of the great potential that computer oversight of patients can have in terms of conserving and more effectively using precious funds and allowing physicians to better serve their patients, reserving office visits only for those patients who truly need face-to-face care.

HIPAA Privacy Rule and Public Health -- Guidance from CDC and the U.S. Department of Health and Human Services
Some public health activities that are initially public health practice may subsequently evolve into a research activity (e.g., an investigation to determine the cause of an outbreak that incorporates a research study evaluating the efficacy of a new drug to treat the illness). When that is the case, the disclosures may be made initially under the public health provisions of the Privacy Rule. But when the activity becomes an ongoing research activity, the entity should consider application of the relevant research disclosures provisions to continue to obtain information for this purpose. Moreover, there may be cases where the activity is both research and public health practice (e.g., an ongoing survey to monitor health conditions in the population, data from which can also be analyzed for research purposes). In those cases, disclosures may be made either under the research provisions or the public health provisions, as appropriate --- the covered entity need not comply with both sets of requirements.

An Institute of Medicine (IOM) Report on Health Professions Education: A Bridge to Quality
While clinicians are trained to use an array of cutting-edge technologies related to care delivery, they often are not provided a basic foundation in informatics. Training in this area would, for example, enable clinicians to easily acces the latest literature on a baffing illness faced by one of their patients or to use the computeriazed order entry systems that automatically flag pharmaceutical contrindications and errors.

Reduce Preventable Medical Errors -- Accurate and complete patient medical information is the key to improved patient safety, better outcomes and fewer errors
Despite the growth of technology to facilitate patient care, patient information continues to be fragmented among different points of service and provider organizations. When patients are presenting for care, providers may be viewing only a partial record, greatly compromising the quality of care. How can your organization ensure rapid access to accurate and complete patient information? This FREE web seminar will present a solution to this pervasive problem that will help optimize the benefits from clinical applications while minimizing errors in patient identification data and the associated clinical information. (April 29, 2003 2 PM EDT)

Project rewards docs for reforms -- Diabetes treatment
Greater Cincinnati will soon become a case study in a national debate about one of medicine's toughest problems - how to provide consistent, high-quality care to people with chronic disease. In Cincinnati, doctors can collect $100 per year per patient who is covered by a participating employer. For a doctor who treats 100 covered diabetic patients, the bonuses could add up to $10,000 a year. In addition, the program offers products and tools to help diabetics get more involved in their care, achieve better outcomes and identify local physicians who meet the high performance measures. Overall, the program is estimated to generate savings of $350 per diabetic patient per year, and cost employers no more than $175 per diabetic patient per year.

Will HIPAA Help?
A cartoon commentary on the new HIPAA regulations.
Other issues from Volume 6 -- 2001

1 -- Jan 1

5 -- Mar 1

9 --- May 1

13 -- Jul 1

17 -- Sep 1

21 -- Nov 1

2 -- Jan 15

6 -- Mar 15

10 -- May 15

14 -- Jul 15

18 -- Sep 15

22 -- Nov 15

3 -- Feb 1

7 -- Apr 1

11 -- Jun 1

15 -- Aug 1

19 -- Oct 1

23 -- Dec 1

4 -- Feb 15

8 -- Apr 15

12 -- Jun 15

16 -- Aug 15

20 -- Oct 15

24 -- Dec 15

4/14/03 dfs

1 -- Jan 1	5 -- Mar 1	9 --- May 1	13 -- Jul 1	17 -- Sep 1	21 -- Nov 1
2 -- Jan 15	6 -- Mar 15	10 -- May 15	14 -- Jul 15	18 -- Sep 15	22 -- Nov 15
3 -- Feb 1	7 -- Apr 1	11 -- Jun 1	15 -- Aug 1	19 -- Oct 1	23 -- Dec 1
4 -- Feb 15	8 -- Apr 15	12 -- Jun 15	16 -- Aug 15	20 -- Oct 15	24 -- Dec 15