We have now reached the point where clinicians are being pushed from every side - industry consortia, government, patients, etc. to adopt clinical IT, often at their own cost and risk. Even suggesting that clinical IT may not be all it is cut up to be can result in highly emotional and unhappy feedback from various circles. It seems to be like suggesting God does not exist to the Vatican.
It also seems never to have occurred to the pundits that doctors are not the venture capitalists and R&D arm of the Acme Anvil EMR Corporation.
I am a strong proponent of good Electronic Medical Records and related clinical IT (CPOE, CDSS, etc.) as tools to facilitate an improved quality of healthcare. However, several caveats apply:
We have often blogged about the tangled web of conflicts of interest that now spans health care. Here is a story about just how tangled that web may be.
Most of the strands were unearther by Dr Daniel Carlat on the Carlat Psychiatry Blog. Dr Carlat published a series of posts about how Eli Lilly and Company funded a continuing medical education (CME) program which first seems to have been produced by a medical education and communication company (MECC), PV Updates. The purpose of the program was ostensibly to educate physicians about risk management. But Carlat thought that the idea was to make learners more comfortable about prescribing risky medications.
Perusal of the online slide show to which Carlat referred immediately suggests how knotty this web may be. The program has a copyright notice from "PV Update Publishing," but a Google search revealed no listing for this company, and the URL
www.update.com yields an error message, albeit with the PVUpdates logo. But the slide show was also noted to be "developed by PRMS, Inc., and under the sponsorship of Eli Lilly and Company." Stay tuned for a moment...
There is yet another twist to the tangled story of conflicts of interest at the renowned Cleveland Clinic.
Two years ago investigative reporting published in the New York Times revealed the complicated relationships among the Clinic, its current CEO Dr Toby Cosgrove, the Clinic's venture capital fund, Foundation Medical Partners, and a small medical device company called Atricure. This coincided with the Clinic's firing of Dr Eric Topol from his leadership positions there. (See posts here and here.) The Cleveland Plain Dealer uncovered more conflicts, involving Dr Cosgrove, the Clinic's board of trustees, Dr Bernadine Healy, and Invacare (see post here.)
In response, last year the Clinic promised to revise its conflicts of interest policy, and held a big conference on the topic of conflicts of interest, although some were skeptical of these efforts (see post here.)
The BBC reports on an innovative laser treatment that Arizona researchers are developing. If perfected the treatment could kill hardy organisms like HIV and MRSA.
It produces lethal vibrations in the protein coat of micro-organisms, thereby destroying them. The effect of the vibrations is similar to that of high-pitched noise shattering glass.
However, the line of attack can be perfected so that the proteins which coat human cells remain unaffected.
Mark Phillips from CBS News explains the surgery that 2-year-old Lakshmi Tatma will be undergoing. She was born with four arms, four legs as well as entangled organs. CBS says Lakshmi is set to have her "parasitic twin" removed in a complex and risky surgery performed by a huge team of 30 doctors. Some positive news here from CNN says Lakshmi's surgery was a succcess.
A new 256-slice CT machine from Philips creates some stunning images that medical professionals can use to find abnormalities and disease. The BBC reports that the new machine produces "3D body images of unprecedented clarity" while also reducing X-ray exposure by as much as 80%.
The new 256-slice CT machine takes large numbers of X-ray pictures, and combines them using computer technology to produce the final detailed images.
It also generates images in a fraction of the time of other scanners: a full body scan takes less than a minute.
On the Hooked: Ethics, Medicine and Pharma blog, Dr Howard Brody discussed a new accusation leveled against those who may criticize relationships among academics and researchers and pharmaceutical, biotechnology and device companies. Dr Brody started by noting
Because those of us who are advocating serious reforms in the medicine-Pharma relationship are finally starting to be heard, we now threaten the industry sufficiently to make us worth powder and shot for a counter-attack.
The latest counter-attack seems to be to accuse those advocating reform of the dread "intellectual bias." This charge surfaced in a response to a letter to the editor in Critical Care Medicine.(1) The letter disagreed with recommendations in guidelines written by the Surviving Sepsis Campaign, and discussed commercial ties of the SSC to the pharmaceutical industry. Note that the authors of the letter, Eichacker, Natanson, and Danner, had previously criticized the SSC guidelines in the New England Journal of Medicine,(2), as discussed in this post.
On the Hooked: Ethics, Medicine and Pharma blog, Dr Howard Brody wrote about his discovery of a web-site entitled, "AIDS Pundits and Ties to Big Pharma," or by its more economic URL,
www.shillfactor.net. The site catalogs, with a degree of sarcasm, the multitudinous financial ties to pharmaceutical manufacturers and biotechnology companies of some of the big wigs in the AIDS/ HIV research and academic world. Some of the individuals have truly amazing numbers of consulting jobs, leading the site writers to speculate how they ever have time to see patients or fulfill their academic responsibilities. The site contains pages for people who "control research," "vote on new drugs," "set treatment specs," "educate the field," "write and report," and ironically, "once were activists." The site is sponsored by Project THAMES, which stands for "transparency in HIV authorship, medical education and scientific investigation." Amazing.
There is a serious outbreak of Ebola fever underway in Uganda. Reuters reports there are 101 suspected cases of Ebola with hundreds more being monitored. 22 people have died so far. 11 health workers are part of the group of people infected with the Ebola virus.
Uganda has 101 suspected cases of Ebola fever and hundreds more people being closely monitored, officials said on Friday, as fear grew in Uganda and neighbouring countries that the deadly virus might spread.
Twenty two people have so far died of the fever and Minister of State for primary health-care Dr. Emmanuel Otaala told journalists 11 health workers have fallen sick.
I wrote here about an "irrational exuberance" regarding electronic medical records (EMR's). Well, here's an example of the escalating irrational exuberance, Don Corleone-style.
A new 256-slice CT machine from Philips creates some stunning images that medical professionals can use to find abnormalities and disease. The BBC reports that the new machine produces "3D body images of unprecedented clarity" while also reducing X-ray exposure by as much as 80%.