Archive for the ‘Public Health’ Category
Wednesday, September 4th, 2013
Guest Author: Maureen “Molly Knapp, Research Support & Education Librarian at Tulane University Rudolph Matas Library of the Health Sciences
In December 2012 I had the opportunity to attend the mHealth Summit in Washington, DC, thanks to the National Network of Libraries of Medicine, South Central Region’s (NN/LM SCR’s) Professional Development Award. The mHealth Summit is an annual event sponsored by the Healthcare Information and Management Systems Society (HIMSS), with strategic support from mHIMSS (a division of HIMSS interested in mobile tech), the National Institutes of Health (NIH), and the mHealth Alliance (an international group with a global focus on the use of mobile devices in health care).
So what is mHealth, you wonder? According to the mHealth Alliance FAQ page:
Mobile Health, or mHealth, can be defined as medical and public health practice supported by mobile devices, such as mobile phones, patient monitoring devices, tablets, personal digital assistants (PDAs), and other wireless devices.
Some uses of mHealth include:
• Education and Awareness – Messaging in support of public health and behavioral change campaigns
• Diagnostic and Treatment Support – Mobile phone as point-of-care device
• Disease and Epidemic Outbreak Tracking – Sending and receiving data on disease incidence, outbreaks and public health emergencies
• Supply Chain Management – Using mobile solution to improve stock-outs and combat counterfeiting
• Remote Data Collection – Collecting real-time patient data with mobile applications
• Remote Monitoring – Maintaining care giver appointments or ensuring medication regime adherence
• Healthcare Worker Communication and Training – Connecting health workers with sources of information
Rest assured, all of these topics and more were addressed at the 2012 mHealth Summit. One of the more provocative keynote sessions I attended was Vinod Khosla’s “Can we have Health and Healthcare without Doctors?” Khosla is a venture capitalist and co-founder of Sun Microsystems. His answer – yes – is detailed in the article “Technology will replace 80% of what doctors do“.
Another interesting panel discussion addressed patient advocacy, featuring Donna Cryer, president & CEO of the American Liver Foundation (@DCpatient) & and Mary Anne Sterling (@SterlingHIT), a health IT consultant and family caregiver. (On a side note, there is a growing role for librarians in patient advocacy, as future MLA programming may soon reveal.)
My favorite, final ‘find’ of the summit was in the Gaming Pavilion in the exhibit hall. There I discovered Tiltfactor Games, specifically a game called ZombiePox, which explores group immunity and the need to vaccinate…WITH ZOMBIES. Tiltfactor was demoing an iPad version of the game, which is unavailable at this time. (Perhaps it was too infected?) With gamification a growing trend in libraries, awareness of companies providing educational, health related games is definitely relevant for collection development. (Also: zombies.)
Overall, the mHealth Summit was heavier on entrepreneurship and investment opportunities and lighter on science. I attended several contributed paper sessions that were hit and miss. Honestly, I don’t know that many librarians would find this type of summit useful to their everyday practice, as it was geared more towards bringing together business and industry. However, for those interested in trends in mobile health technologies and its application to public health and health care, or those who have a really cool app or website in need of a wealthy investor, the mHealth Summit is definitely your scene.
Monday, September 2nd, 2013
This September marks the 10-year-anniversary of National Preparedness Month (NPM)! Since its inception in 2004, The Federal Emergency Management Agency (FEMA) has partnered with other government organizations (such as the Centers for Disease Control and Prevention) in an effort to encourage communities and individuals to be prepared for the worst in emergency situations.
As one part of FEMA’s NPM initiative, the National Preparedness Community website offers a multitude of resources for users and community members. Included on the website is a tool-kit with marketing information and a comprehensive list of NPM videos, PDFs, and webpages. In addition, users can use the National Preparedness Community website to find NPM events happening in their area or register for free with the community and access additional resources, such as discussion forums and region-specific activity.
In addition to the National Preparedness Community website, the American Public Health Association (APHA) will be celebrating Get Ready Day on September 17th as part of NPM. The Get Ready website contains many fun and education resources for a variety of users and communities. These resources include factsheets, videos, podcasts, and other disaster preparedness-themed media for marketing use.
Additional information on National Preparedness Month can be found on these websites:
Centers for Disease Control and Prevention – Be Ready! : http://www.cdc.gov/features/BeReady/index.html
National Library of Medicine Disaster Information Management and Resource Center homepage : http://sis.nlm.nih.gov/dimrc.html
APHA Get Ready : http://www.getreadyforflu.org/newsite.htm
Ready.gov (from FEMA) : http://www.ready.gov//www.getreadyforflu.org/newsite.htm
Wednesday, August 28th, 2013
Germs are everywhere. Touching dirty surfaces has always been a concern. Disinfection stations for cleaning hands have shown up in schools, restaurants, gyms, and countless other public places. But what about the germs that transfer from hands to mobile devices? The use mobile devices with touchscreens continues to rise but disinfecting these devices can be problematic. According to many mobile device manufacturers the use of liquids, including disinfecting liquids, on the special touchscreen is not recommended. Some manufactures warn that using liquids may damage the touchscreen or void the product warranty.
The use of tablet devices in hospital and healthcare settings poses a unique situation. In clinical settings the use of a tablet device by clinician or patient may occur. The transfer of germs from one patient to another or to the care provider via a tablet screen may occur if tablets are not properly disinfected.
A recent study published in the Journal of Medical Internet Research found that “Normal use of tablet PCs leads to a remarkable amount of microbial surface contamination.” And “every fingerprint on the surface will leave residue on the glass, aluminum, and plastic parts of the device and may contain a large number of bacteria. An increased awareness of this fact is required when those devices are used during patient care.”
In this study ten iPad devices were used and tested during the study period to determine the best method for disinfection of the devices. The study found that the recommended cleaning method suggested by manufactures, a lint-free cloth without liquid cleaning agents, results in a reduction rate of 51.1% bacterial colony forming units. However when isopropanol wipes were used along with proper cleaning protocols reduction and inactivation of residual bacteria occurred.
Unfortunately recent changes in care policies from device manufactures suggests that the use of any liquid including that found in the isopropanol wipes will result in voiding of the manufacturer warranty.
The study also used the deBac-app as a tool to help devices owners follow proper cleaning protocols to ensure the maximum reduction on bacteria on the devices. The app which is free from the iTunes App Store helps document the cleaning process as well as keep a log of when cleanings occur.
Overall, mobile device owners should take care to minimize the amount of bacteria present on devices to ensure the health and safety of those using the device. One of the best way to minimize bacteria present on tablet devices is to follow methods for proper disinfection of the hands before and after each patient interaction.
Tuesday, August 27th, 2013
New preliminary reports from the Centers for Disease Control and Prevention (CDC) estimate that around 300,000 Americans are diagnosed with Lyme disease each year—an estimate ten times higher than the yearly reported number of 30,000. These estimates are based on results from three ongoing studies by the CDC that use various methods to define the average number of people diagnosed with Lyme disease. From the CDC brief:
The first project analyzes medical claims information for approximately 22 million insured people annually for six years, the second project is based on a survey of clinical laboratories and the third project analyzes self-reported Lyme disease cases from a survey of the general public.
The high number of Americans diagnosed with this disease highlights the need for awareness and prevention.
Although the backlegged ticks carrying Lyme disease are found all over the United States, most cases are reported in the Northeast and upper Midwest regions. A tick bite is most often characterized by a “bulls-eye” rash (or erythema migrans) that forms around the location of the bite and occurs in the majority of those infected within 3-7 days. Additional common side effects include fever, headaches, joint aches, and chronic fatigue. You can prevent and control Lyme disease by wearing repellents that contain 20 – 30% DEET (N, N-diethyl-m-toluamide) on both exposed skin and clothing. It is also important to be aware of whether or not you’re in a highly tick-populated area and perform full-body tick checks when you are finished with your outdoor activity.
For more information on ticks, Lyme disease, and the CDC studies, visit the following links:
Centers for Disease Control and Prevention – Lyme Disease: http://www.cdc.gov/lyme/
Centers for Disease Control and Prevention Newsroom – Press Release – http://www.cdc.gov/media/releases/2013/p0819-lyme-disease.html
MedlinePlus – Lyme Disease – http://www.nlm.nih.gov/medlineplus/lymedisease.html
Thursday, August 1st, 2013
The Robert Wood Johnson Foundation recently released the Health Information Technology in the United States 2013: Better Information Systems for Better Care Report.
According to the report “since 2010, the proportion of hospitals having a basic electronic health record (EHR) has tripled.” With “more than 38 percent of physicians reporting having adopted basic EHRs in 2012.” With incentive programs for health information technology (HIT) adoption, such as the Health Information Technology for Economic and Clinical Health (HITECH) Incentive Program many hospitals were able to take steps and move toward EHR system adoption. The report shows that while adoption in hospitals was large, the increase in adoption of EHR systems by physicians in private practice was not as large. Small practices continue to lag behind in EHR adoption and will likely need continued support from agencies such as Regional Extension Centers (RAC).
In a positive finding the report shows that “physicians and hospitals alike appear to be adopting EHRs with more sophisticated capabilities that enable improvements in the delivery of care and management of patient populations.” The report also suggests that many hospitals are adopting at least as basic EHR system (44 percent) while only 16.7 percent of hospitals have already adopted a comprehensive EHR system.
According to the report four areas where most organizations which have adopted EHRs lag behind are related to patient clinic summaries and include the ability for the patient to view quality data, receive guideline reminders, receive patient e-copy of health information, and provide patient clinical summaries.
The report goes on to compare HIT implementation in the US to HIT implementation in other countries as well as provide additional insights into the development of Health Information Exchanges and their role in healthcare.
The final chapter of the report deals specifically with “Improving Patient Education with EHRs” an area many hospital and consumer health librarians are familiar with. According to the report “little is known about best approaches for using EHRs to provide patients with materials that are understandable and actionable for patients, especially those with limited health literacy and English proficiency.” The report provides a good study of vendors in the EHR industry and specifically looks at patient health information portals and delivery.
The report suggests that “U.S. providers could do more using HIT to engage patients with educational materials tailored to an individual’s diagnosis and health literacy level.”
Overall, this is a valuable report for those involved in HIT and EHR implementation. Using the data provided in this report librarians can demonstrate the value of consumer health information resources such as MedlinePlus and MedlinePlus Connect in meeting Meaningful Use objectives.
Tuesday, July 30th, 2013
As reliance on and use of mobile devices continues to grow worldwide, the use of these devices to aid in disaster recovery and relief efforts is becoming more commonplace. Earlier this month the Center for Technology and Innovation at the Brookings Institute released the report “How Mobile Devices Are Transforming Disaster Relief and Public Safety” which provides a more in-depth assessment of how mobile devices and mobile technology are transforming disaster relief and public safety.
Mobile devices including smart phones and tablets are enabling both the general public and emergency responders to stay connected to important information in times of crisis. According to the report mobile devices provide early warning systems, aid in the coordination or emergency response, and improve public communications.
The report provides real world situational examples of how mobile technology has been used in response to natural disasters such as earthquakes and as well as for emergency preparedness. According tot he report, mobile devices are also playing an important role in alerting the public to events such as terrorist attacks and shooting incidents. The report includes examples of smartphone applications that have been created to help individuals in an attack scenario find safety. The use of mobile devices for improved public safety has also led to the development and use of mobile applications for sending alerts to notify users of events happening or reported in their area.
The report includes many examples of applications and uses of mobile technology for emergency preparedness, disaster recovery, emergency education, alert systems, and other forms of communication. The global reach of mobile devices continues to transform disaster response efforts around the world.
Monday, July 22nd, 2013
According to the National Oceanic and Atmospheric Administration (NOAA), heat kills an average of 1,500 people a year in the US—a number higher than any other weather-related event. The Red Cross defines some terms that you may hear regularly during hot weather months:
- Excessive Heat Watch - Conditions are favorable for an excessive heat event to meet or exceed local Excessive Heat Warning criteria in the next 24 to 72 hours.
- Excessive Heat Warning - Heat Index values are forecasting to meet or exceed locally defined warning criteria for at least 2 days (daytime highs=105-110° Fahrenheit).
- Heat Advisory - Heat Index values are forecasting to meet locally defined advisory criteria for 1 to 2 days (daytime highs=100-105° Fahrenheit).
During times of extreme heat everyone–but especially infants, children and adults over the age of 65–are at an increased risk of suffering from a heat-related illness. Some of the most common include heat cramps, heat exhaustion, and heat stroke (or sunstroke).
So what can you do to stay safe during the hot weather?
For more information about extreme heat safety, visit the following:
Center for Disease Control and Prevention site on Extreme Heat Emergency Preparedness and Response
Environmental Protection Agency’s Excessive Heat Events Guidebook
NOAA Tips for Staying Healthy and Cool During the Summer
National Weather Service/NOAA page on Heat (including heat index numbers and information)
Wednesday, July 17th, 2013
Patient safety in hospitals is a topic important to everyone, but it can be difficult to understand all of the issues involved. The Agency for Healthcare Research and Quality’s Patient Safety Network provides a series of Patient Safety Primers to guide people through key concepts in patient safety: http://psnet.ahrq.gov/primerHome.aspx
There are over 20 Primers available. Some of the topics are:
- Adverse Events after Hospital Discharge: Nearly 20% of patients experience an adverse event in the first 3 weeks after discharge, including medication errors, health care–associated infections, and procedural complications. http://psnet.ahrq.gov/primer.aspx?primerID=11
- Checklists: Though a seemingly simple intervention, checklists have played a leading role in the most significant successes of the patient safety movement, including the near-elimination of central line–associated bloodstream infections in many intensive care units. http://psnet.ahrq.gov/primer.aspx?primerID=14
- Diagnostic Errors: Thousands of patients die every year due to diagnostic errors. While clinicians’ cognitive biases play a role in many diagnostic errors, underlying health care system problems also contribute to missed and delayed diagnoses. http://psnet.ahrq.gov/primer.aspx?primerID=12
- Disruptive and Unprofessional Behavior: Popular media often depicts physicians as brilliant, intimidating, and condescending in equal measures. This stereotype obscures the fact that disruptive and unprofessional behavior by clinicians poses a definite threat to patient safety. http://psnet.ahrq.gov/primer.aspx?primerID=15
- Error Disclosure: Many victims of medical errors never learn of the mistake, because the error is simply not disclosed. Physicians have traditionally shied away from discussing errors with patients, due to fear of precipitating a malpractice lawsuit and embarrassment and discomfort with the disclosure process. http://psnet.ahrq.gov/primer.aspx?primerID=2
- Nursing and Patient Safety: Nurses play a critical role in patient safety through their constant presence at patient’s bedside. However, staffing issues and suboptimal working conditions can impede nurses’ ability to detect and prevent adverse events. http://psnet.ahrq.gov/primer.aspx?primerID=22
- Wrong-Site, Wrong-Procedure, and Wrong-Patient Surgery: Few medical errors are as terrifying as those that involve patients who have undergone surgery on the wrong body part, undergone the incorrect procedure, or had a procedure intended for another patient. http://psnet.ahrq.gov/primer.aspx?primerID=18
Patients also have a part to play in ensuring that they have safe healthcare, as described in the following Primer:
- The Role of the Patient in Safety: Efforts to engage patients in safety efforts have focused on three areas: enlisting patients in detecting adverse events, empowering patients to ensure safe care, and emphasizing patient involvement as a means of improving the culture of safety. http://psnet.ahrq.gov/primer.aspx?primerID=17
Would you like to know more? Go here for the complete list of Patient Safety Primers http://psnet.ahrq.gov/primerHome.aspx
Tuesday, June 25th, 2013
Last month, the NN/LM SCR was invited to attend the spring meeting of the HSLAL (Health Sciences Library Association of Louisiana), held at the National Hansen’s Disease Museum in Carville, LA. This fascinating Museum, located between Baton Rouge and New Orleans, was the only National Leprosarium in the United States, and today the Museum collects, preserves, and interprets the medical and cultural artifacts of the Carville Historic District and promotes the understanding, identification and treatment of Hansen’s Disease (for more information, see MedlinePlus Health Topics page on Hansen’s Disease or leprosy).
The Museum today is a monument to those who battled Hansen’s Disease (HD) – researchers, health care professionals and patients who suffered from the affliction. Today, a patient diagnosed with HD is treated as an outpatient. In 1894, when the Louisiana Leper Home was established on an old plantation site, a diagnosis of leprosy meant forced quarantine, little treatment, and no cure, as well as separation from family, home and community. The federal government took control of the facility in 1921, and continued to house patients until 1999. Currently, the Louisiana Military Department occupies the 400-acre site and only a handful of elderly patients remain at the facility.
Learn more about this interesting U.S. Public Health Service site and part of U.S. history by visiting in person or through virtual tours on the website. The autobiography of Stanley Stein (an alias chosen to protect his family from stigma), Alone No Longer, provides great insight into the life of millions of leprosy patients around the world in the 20th century. Within months of his arrival at Carville, Mr. Stein had founded a newspaper to campaign for the rights of leprosy patients around the world. “Hansen’s disease victims who today may enjoy a normal life owe much to the efforts of one man – Stanley Stein” (from the forward to the book by Lawrence G. Blochman).
Thursday, June 6th, 2013
The National Center for Health Statistics(NCHS) has published Health, United States for 2012.
Health, United States is an annual report on trends in health statistics. Visit the NCHS site for data on selected topics, at-a-glance tables, as well as the full report.