sharing the digital experience
{ Category Archives }
Hannah Seligson blogs about how “the Siruis radio show Be Happy, Dammit gathered a dynamite panel to talk about work-life balance and how women can often be their own obstacle in the workplace.” One quote is “that women magnify the importance of things. Her advice is to reprioritize.” She links to the radio post.
Mashable is a geek’s good friend, sometimes good for non-geeks too 
notes from the field
Suffering Differently
By Ethan Watters, The New York Times Magazine, August 12, 2007
After the 2004 tsunami in Asia, many mental-health experts agreed that a “second tsunami” of mental illness in the form of post-traumatic stress disorder would strike the region. Like doctors rushing to the outbreak of an epidemic, American counselors and trauma researchers soon arrived on the scene hoping to pass on useful knowledge about PTSD. A few years on, however, their efforts have raised a troublesome question: Were they bringing the wrong treatment to the wrong people?
At issue is not whether tragic events like the tsunami trigger debilitating psychological distress and even mental illness — everyone agrees that they can. The question is over the extent to which survivors’ cultural beliefs shape their symptoms. If culture has the impact that some researchers suggest, the PTSD diagnosis may be of little help (and even do potential harm) when applied wholesale in other countries.
In the last 25 years, PTSD has had a remarkable ascendancy in American psychiatry and in public consciousness. Proponents of the diagnosis assert that experiences of fear or horror often spark a cluster of 17 broad symptoms, including intrusive thoughts, memory avoidance and uncontrollable anxiety. The concept of PTSD also encompasses notions of how best to overcome the disorder, usually through measured re-exposure to the original trauma supervised by a counselor. PTSD, many Americans assume, describes the way that all humans react to trauma.
Gaithri Fernando, an expert on trauma from California State University, questions that assumption. “Researchers and counselors who came to Sri Lanka after the tsunami did find some PTSD symptoms,” Fernando says. “But it was not the nightmares or flashbacks that most of the population was concerned with. The deepest psychological wounds for Sri Lankans were not on the PTSD checklists; they were the loss of or the disturbance of one’s role in the group.”…
Eye on DNA Headlines for 12 August 2007
by Dr. Hsien-Hsien Lei, Posted August 12, 2007
includes:
Matt Ridley writes in The Agile Gene:
If personality is created by parents, peers, or society at large, then it is still determined; it is not free.
In some ways the news that our genes are important contributors to our personality should be reassuring: the imperviousness of individual human nature to outside influences provides a bulwark against brainwashing. At least we are determined by our own intrinsic forces rather than somebody else’s.
A more non-trauma, non-DNA US culture view at: Culture, Counterculture #1
There are many efforts afoot to make Health Records management more economical and more reliable. Another less obvious value is facilitating distributed specialized support so the patient doen’t need to leave their community to be near the specialist, rather the specialist can monitor remotely and work through the local health care community. Of course there are times one must go to the specialist, but why not attempt to minimize that since there are social costs, financial costs and patient discomfort and disharmony as a result.
Minnesota First State to Require Electronic Submission of Health Transactions¹
Minnesota is now the first state in the nation to require all health care payers and providers to submit claims and eligibility transactions electronically using a common format starting in 2009. The new requirements, signed into law by Governor Tim Pawlenty as part of the 2007 Omnibus Health and Human Services funding bill, apply to all health care providers and affects virtually anyone who bills for or buys health care services on behalf of a group of people. Electronic administrative health care transactions can reduce costs and improve the efficiency of health care….
Implementing an EHR: Going live is no snap²
Problems, snafus, and some victories take place as three different practices start using their new EHRs.
The only thing you can count on when implementing an electronic health record system is that little will go according to plan. In this second article in our series on implementing an EHR, three small and medium-sized practices report on the unexpected and often frustrating problems they encountered when they turned on their new EHR and practice management systems….
After nearly two decades in health care administration, it is apparent to me that the System is shaking out in ways that may prove to be both very interesting and disparaging to many of our citizens. In the recent Wall Street Journal Article, Care Gap Hospital Building Boom Sparks Fear Cities Will Be Left Behind, the nuances of the current five year, $100 billion building expansion that has taken place from 2000 to 2005 in the industry, the majority of that construction has occurred in the suburbs in order to allow the hospitals to target the affluent. This, according to the article, has resulted in a financial struggle for the urban centers that often treat the poor. The result of this movement? “Scores have had to shut their doors.”….
The partial answer is things like these:
¹ Jun 28, 2007, GovTech News Report
² Ken Terry, Medical Economics, Jul 6, 2007
³ World Health Care Blog, by Nick Jacobs, July 6, 2007
aka Security and Privacy
I woke up this morning thinking about governance and transparency (ok, I think about weird things, get over it).
There are conflicts and debates buried in the ideas of Security and Privacy that we deal with all the time.
But there are some that don’t need to be there in the digital world.
23andMe is a privately held company developing new ways to help you make sense of your own genetic information.
Silicon Valley Wide-Eyed Over a Bride
By KATIE HAFNER, The New York Times, May 29, 2007
Esther Wojcicki, who has worked at Google as an educational consultant, described her daughter as “an idea factory.” In the past, she said, her daughter has had various health care related business ideas, and 23andMe is the first to come to fruition. Ms. Avey, her partner, has been involved with several start-ups in the past….
“This is a completely new thing, and that’s exactly why we invested,” said Patrick Chung, a partner with New Enterprise Associates, a venture capital firm in Menlo Park, Calif. “Everyone can relate to this. Everyone has a genetic blueprint.”…
Little Geniuses
What kind of praise do kids need to hear?
By Emily Bazelon, Slate
Posted Friday, May 11, 2007, at 12:09 PM ET
and, somehow related:
In which I discover that I’m an omnivore
by Bertalan Meskó
I’ve recently decided to deepen my knowledge on the field of personalized genetics/genomics as it has an exceptional future in the realm of medicine (and business). And who is the right person to answer my geek questions? Of course, Steven Murphy, MD, the blogger of the Gene Sherpa. He is the Clinical Genetics Fellow at Yale University and is also the founder of a Personalized Medicine practice.
We’ve heard a lot about personalized medicine, but please tell us more about personalized genetics.
Sure. There are some fundamental differences here. When I think about
personalized genetics (Which is different than personalized genomics) I think about modifier genes involved in single gene disorders such as Cystic Fibrosis…..
Should we treat you aggresively or not? This woman clearly did ok without Creon (pancreatic enzymes), aggressve pulmonary toilet, or inhaled antibiotics. Now with the newborn screen we detect so many more patients with Cystic Fibrosis. Who should we treat? How should we treat? Personalized Genetics is like personalized medicine for those with single gene disorders. I remind you that “No gene is an Island” so we need to take it in context of the rest.
Personalized genetics or genomics? Is there any important difference?
…This is the dream of everyone gets a genome sequenced at birth, we assess risk, create prevention plans, identify idosyncratic drug reactions prior to medication therapy….
Legendary physicist David Deutsch back-burners the work for which he’s best known — quantum physics, quantum computing, the many-worlds theory — to discuss a more basic topic: how to think about our species’ significance in the universe. Far from being simply “chemical scum,” we have the ability to gain knowledge, the importance of which he illustrates in spectacular manner. As a result, he says, we are always equipped to solve problems (including global warming). The brain contains the tools we need: knowledge, reason and creativity. It’s a thrilling, and profoundly optimistic argument.
Provisioning for non-employees in healthcare organizations
Continuing our look at identity and healthcare
Identity Management Newsletter By Dave Kearns, Network World,
05/14/07
Speaking of identity and healthcare, as we were in the last issue, I sat in on a panel discussion last week on provisioning non-employees in a healthcare environment. This was just one of the many fascinating sessions at this year’s (the fifth annual) Converge conference, the user conference put on by Courion and its partners Citrix, Cyber-Ark, Encentuate, RSA, Diaphonics, HealthCast, Imprivata and Radiant Logic – fairly familiar names to readers of this newsletter.
Most of you who handle aspects of provisioning for your organization will, sooner or later, come up against the problems of handling non-employees. Not that provisioning of employees is without problems, but it’s usually fairly easy to identify such things as the kick-off points for the provisioning and deprovisioning workflow. Non-employees, however, rarely touch the human resources department, nor do they all typically flow through any one particular point. Where there are few non-employees a virtually ad-hoc solution can be used, tailored to each one’s needs. In healthcare, though, as with one or two other fields, such as education, the number of non-employees needing access to some or most of the organization’s resources can often easily exceed 50% of the total user base. Also, these non-employee users don’t break down into one or two general categories as they do in some other industries. Retail, for example, could have more non-employees than employees but the bulk of them could be divided into two categories - customers and suppliers – each with fairly well-defined roles….
By reading the white papers and case studies associated with identity management in healthcare we can discover lots of tips that can be applied to other industries as well as pitfalls that can be avoided.
Here are a few to get you started.
* Stamford: A Case Study - The case study describes the challenges faced by Stamford Hospital and how Encentuate helped Stamford achieve the proper balance between ease of access for caregivers and adequate security compliance.
* Novell Case Study - Catholic Healthcare West wanted to create a standard approach to identity and access management that would increase security and meet regulatory requirements, while still giving physicians and staff fast access to applications.
* Imprivata and Courion relieve password and user provisioning woes at Moffitt
Cancer Center.
There are more out there, and I’ll point you to them from time to time.
For now, though, read and learn from these….