News-Record.com

Here's my article on the issues physicians face when considering whether to convert to electronic medical records. Dr. Mary Johnson adds one that I didn't cover: how having medical records would add to the value of a practice when it comes time for the practitioner(s) to sell the practice.

Could there be a genetic basis for some speech and language impediments? An article in The New England Journal of Medicine examines the possibility, and the journal also opines on it.

In the age of massive bank bailouts, nobody seriously believes that every change called for in President-elect Barack Obama's health-care plan can be implemented. But Robert Laszewski over at the blog Health Care Policy and Marketplace Review points to some things we can do right now,some of which have bipartisan support, to help reduce health-care costs, particularly the waste that may constitute up to a third of our annual $2 trillion-plus health-care bill. It's worth a read.

Diabetes is moving from disease to public-health menace in terms of its scale. But a cure remains elusive.

Wake Forest University Baptist Medical Center, through its Diabetes Research Center, is researching diabetes on a number of fronts. To better share information on those efforts with the public, it has created a Web site.

“Diabetes mellitus is the pandemic of the new millennium,” Donald W. Bowden, Ph.D., director of the Diabetes Research Center, said in a news release. "It can be a devastating disease, affecting the heart, kidneys, eyes, nerves and brain. Our scientists and physicians are tackling diabetes from every angle looking for solutions.”

In diabetes, the body either fails to produce enough insulin or fails to properly use it to metabolize blood sugar. Insulin is a hormone that is essential to convert sugar from food into energy.

Almost 8 percent of Americans have diabetes, the U.S. Centers for Disease Control and Prevention estimates, and their risk of death is twice that of comparable Americans without the disease.

My story on medical practices switching to electronic medical records is here.

Dr. Mary Johnson points out one other benefit (to doctors) that I didn't address in my story: the likely increase in the "resale" value of a practice with electronic records:

But once the switch to EMR is made, the physician has a much better bargaining chip . . . if he/she ever wants to sell . . . than he/she would have with room full of paper charts that the buyer will almost certainly have to scan/convert.

The patient data all neatly recorded on computer hard-drive or disk is worth something . . . and can go to the highest bidder (perhaps recouping at least a portion of the investment - if not all of it).

For financially struggling docs (and, yes, there are some), particularly the many nearing retirement age, that's certainly another benefit.

You might have seen the wire story in Monday's N&R about a report at the American Heart Association's meeting in New Orleans about cholesterol-lowering drugs, or statins. As the Bloomberg News Service put it, "AstraZeneca Plc's Crestor [a cholesterol-lowering medication] slashed the risk of heart attack, stroke and death by nearly half in people with normal or low cholesterol in a study, potentially opening a way to save the lives of thousands of seemingly healthy people.”

As is usually the case with medical research, there's more to this research than the headlines, and there are questions the research did not answer.

Maggie Mahar at the Health Beat blog analyzes the issues and raises some points and questions that you really ought to be thinking about, and asking your doctor about, before you run out and ask your doc for a statin prescription you'd need to take for the rest of your life.

The Center for American Progress is a liberal think tank likely to contribute both staff and ideas to President-elect Barack Obama's administration. It has a lengthy report here addressing some of the issues involved in reforming our health-care system to get care to more people who need it.

(hat tip: The Health Care Blog)

Where's the flu? Google can tell you.

Its nonprofit arm, Google.org, is mapping reports of the flu, based on how often "flu" and related words/symptoms are used for searching. You can see it here. The Wall Street Journal provides more detail, including the fact that the site will contain no advertising. The flu site also charts the number of searches for "flu." The site uses aggregate data and does not include personally identifying information in its calculations, the WSJ says.

You can Google other search trends at google.com/trends. Naturally, I Google-trended myself, but the result contained too few hits for a meaningful graph, Google's computers said. Unfortunately, so did the phrase "highway bonds," so I'm not sure just how often something has to be used as a search term before it registers.

"Carolina Panthers," on the other hand, generated a chart dating back to early 2004. It appeared to begin with a downslope from the Panthers' Super Bowl appearance after the 2003 season and spiked greatly in late 2005, when the Panthers went to the NFC championship game before losing to Seattle.

But: flu. It's that time of year again, and as you no doubt have tired of hearing, flu is a big public-health deal. So if you're vulnerable, particularly if you have a compromised immune system, you might want to check Google Flu Trends before going to visit your grandmother in another state for Christmas.

That's the conclusion of a study reported today in the Boston Globe. Massachusetts communities began banning smoking in most workplaces in the early 2000s; the legislature enacted a statewide ban in 2004.

The report doesn't appear to claim a causal connection -- although its authors do -- but it both documents a strong correlation, based not only on numbers but also related to the times at which the various bans took effect. And it explains how cigarette smoke can cause heart problems more quickly than it can cause its more familiar consequences for the respiratory system. The number of Massachusetts residents who died of heart attacks decreased by almost 600 per year, or about 30 percent, after the bans took effect.

Commenters as of a little before 11 a.m. today have been overwhelmingly critical, but other than pointing out the difference between correlation and causation, none has offered a scientific basis for challenging the findings.

U.S. Sen. Max Baucus, who chairs the Finance Committee, has been working on health-care reform since long before Barack Obama was elected president. (Any legilsation on this subject would have to go through his committee.) This week he released a white paper, which he says is not proposed legislation but a "Call to Action." (Executive summary here (scroll down a bit); full text here.)

The highlights: 1) Baucus seems to be threading the needle between the practical issue of how quickly anything could be enacted (he says at least three years) and the urgent need to move as quickly as possible. And 2) he would require everybody to buy health insurance (with a sliding price scale to benefit the less-well-off), balanced by the kind of protection for people with pre-existing conditions that's rare, if not impossible to find, in the free market.

He doesn't say anything about how to pay for the plan, possibly because it's kind of vague.

Maggie Mahar of the Health Beat blog has a 2-part analysis up (Part 1, Part 2). Given Baucus' committee chairmanship, there's a strong possibility that any legislation that does come to pass will look a lot like this "Call to Action."

Robert Laszewski at Health Care Policy and Marketplace Review also analyzes the plan.

Thursday is the American Cancer Society's annual Great American Smokeout promotion, which aims to get smokers to quit.

But smokers aren't the only users of tobacco. An estimated 6 million Americans use chewing tobacco or snuff, referred to as smokeless tobacco. And they run elevated cancer risks, too, although of different kinds of cancer than those most often attributed to smoking. About 9 million Americans die annually of diseases related to smokeless tobacco.

Now there's a new Web site aimed at helping young users of smokeless tobacco -- those between ages 14 and 25 -- to get rid of that habit. MyLastDip.com, sponsored by the National Cancer Institute and directed by the nonprofit Oregon Research Institute as part of a study, is a Web site that offers ways for such users to quit.

Participants are asked to fill in a questionnaire to help the institute with its research, but the services are free.

That's what the research is saying:

An extensive federal report released Monday concludes that roughly one in four of the 697,000 U.S. veterans of the 1990-91 Gulf War suffer from Gulf War illness.

That illness is a condition now identified as the likely consequence of exposure to toxic chemicals, including pesticides and a drug administered to protect troops against nerve gas.

The 452-page report states that "scientific evidence leaves no question that Gulf War illness is a real condition with real causes and serious consequences for affected veterans."

The report, compiled by a panel of scientific experts and veterans serving on the congressionally mandated Research Advisory Committee on Gulf War Veterans' Illnesses, fails to identify any cure for the malady.

It also notes that few veterans afflicted with Gulf War illness have recovered over time.

So about 175,000 Gulf War veterans were poisoned by their own government, with serious and, likely, permanent consequences.

If we honor military service, we Americans now have a big job on our hands ... and that's just to take care of our own. What might we owe foreign nationals also exposed to the chemicals?

Coincidentally, I have stumbled across a few readings lately that all make the same basic point: in a society growing ever more diverse, medical personnel must be sure they understand what they hear, and sometimes even the culture behind what they hear, if they are to treat patients correctly. One horror story, albeit an old one, about what happens when that understanding isn't achieved is here.

Which reminds me of something I learned in 10th-grade Spanish: "embarazada" does not mean "embarrassed".

It's tomorrow, and the Guilford County Department of Public Health has some info and resources posted on its blog. If you smoke and want to quit, hie thee hence.