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How Practices Can Compete With Walk-in Clinics

by System Administrator - Thursday, 8 January 2015, 2:40 PM

How Practices Can Compete With Walk-in Clinics

Consumers are accustomed to new medical practices emerging in their community from time to time and so are physicians. This is not unusual, but now we are seeing a new kind of medical practice popping up all over the place. They are at Wal-Mart, Walgreens, and even on the corner strip malls. These new competitors are walk-in clinics, known by a variety of names, like Minute Clinic, promising easy access and convenience that is not always available in the typical medical practice — whether you are a primary-care physician or a specialist. So how do you compete? 

First of all, don't assume you know more about these clinics than you actually do. Find out all you can about these clinics, and discover what you have to offer patients that they don't. You might even want to explore the possibility of collaborating with a local walk-in clinic, based on the unique services that your practice provides. For example, if its goal is to only see patients with an acute illness or injury, but not provide ongoing care, you might be able to secure referrals for patients needing follow-up care. If providers at the clinic treat a patient for a cough, but discover he has high blood pressure, could you become the cardiologist of choice? And if you don't treat patients for workers compensation injuries, perhaps there's an opportunity for cross referrals.

Many of these clinics are employing nurse practitioners or physician assistants. Meet these providers and talk about being available for consult, if they have questions when treating a patient that presents with unusual symptoms. Check out their qualifications, experience, and areas of expertise. If you feel confident in their capabilities, it might make sense to refer your patients to their clinic for urgent, after-hour care like an ankle sprain, a cough, or a fever — as long as patients know they should return to you for follow-up care. For patients that do not have serious symptoms, it can be more advantageous to visit a walk-in clinic than being seen in an emergency room that has higher costs and often longer wait times.

It's really all about better channels of communication and building a supportive clinical relationship that nurtures opportunities for collaborative patient care, improving patient compliance, and providing for continuity of care. Isn't that really what we all want? In the end, it may even contribute to managing medical expenses better without compromising clinical outcomes.


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How to Apologize for a Medical Error

by System Administrator - Friday, 27 February 2015, 12:54 PM

How to Apologize for a Medical Error


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How to Deal with an Annoying Medical Practice Coworker

by System Administrator - Thursday, 8 January 2015, 2:48 PM

How to Deal with an Annoying Medical Practice Coworker

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How to Leverage a Big Data Model in the Network Monitoring Domain

by System Administrator - Tuesday, 7 October 2014, 9:05 PM


How to Leverage a Big Data Model in the Network Monitoring Domain

Network monitoring is on the cusp of a radical shift away from the prevailing paradigm of appliance-only deployments. Because of this rapidly changing architecture, IT teams need to keep pace with the changes to give their users and employees as much visibility as possible. Download this whitepaper to learn how to leverage a big data model in the network monitoring domain and see why IT is shifting away and how your team should react to keep up.

Please read the attached whitepaper.

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How to Train Thousands of Surgeons at the Same Time in Virtual Reality

by System Administrator - Sunday, 16 October 2016, 11:05 PM

How to Train Thousands of Surgeons at the Same Time in Virtual Reality


Recently, I wrote about how the future of surgery is going to be robotic, data-driven and artificially intelligent.

Although it’s approaching fast, that future is still in the works. In the meantime, there is a real need to train surgeons in a more scalable way, according to Dr. Shafi Ahmed, a surgeon at the Royal London and St. Bartholomew's hospitals and cofounder of Medical Realities, a company developing a new virtual reality platform for surgical training.


An operating theater.

Hundreds of years ago, training happened in an “operating theater,” where many would-be surgeons peered over each other’s shoulders to try to get a glimpse of the action and learn as best they could. The reality is, this method of training still hasn’t changed much to this day.

At the same time, two thirds of the global population still doesn’t have access to safe and affordable surgery.

According to the Lancet commission on global surgery, the surgical workforce would have to double to meet the needs of basic surgical care for the developing world by 2030.

Dr. Ahmed is working to solve this problem. He imagines being able to train thousands of surgeons simultaneously in virtual reality.

Speaking at this year’s Exponential Medicine conference, Ahmed painted a vivid picture of the need for a scalable surgical education.

“Imagine that you're a surgical trainee in Tanzania. You're restrained by geography, you're in a rural setting, but you want some training. You want to improve the standards of your health care system, as every doctor does… Imagine you're a surgeon, maybe an attending in Bangladesh, a population of 150 million with a very poor infrastructure of training and teaching….Imagine you're a school kid in a inner city area, a poor district. But then you want to be a surgeon, you want to train to be a medic, you want to access information. You'd like to know what it's like and immerse yourself.”

Ahmed believes that education is a basic, fundamental right for everyone and that with virtual reality, he can train surgeons across the world in a way that has not been possible before today. 

Dr. Ahmed has already made some steps towards this reality. In May of 2014, he streamed a training session through Google Glass, reaching 14,000 surgeons across the world.  

In April of 2016, he live-streamed a cancer surgery in virtual reality. The procedure, a low-risk removal of a colon tumor in a man in his 70s, was filmed in 360 video and streamed live across the world. The high-def 4K camera captured the doctors’ every movement, and those watching could see everything that was happening in immersive detail.

[Note: This video shows a live surgery. Content may be too graphic for some viewers]

Surgical Training in 360-Degree Virtual Reality for Oculus Rift (with intro + narration)

This is a 360 degree video, click and drag to change the angle of view.
Watch using Chrome browser on desktop or the YouTube app on Android devices to view in 360 degrees.
Click 'SHOW MORE' below for more information.

So today, we already have the technology to allow medical students to stand in the shoes of an experienced surgeon. What’s next for surgical education?

“In time, we [will be] wearing gloves or body suits [so] we can touch and feel things in the virtual world. Then ultimately, imagine being a virtual surgeon, where you pop into a virtual theater [with] virtual patient [and] virtual instruments and do a virtual operation,” says Ahmed.

First Oculus Rift Surgery

This video is a teaser of a project funded by the MOVEO Foundation aiming to improve surgeon training.

Want to keep up with coverage from Exponential Medicine? Get the latest insights here.

Image credit: Shutterstock


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How wearable cameras can help those with Alzheimer's

by System Administrator - Monday, 11 August 2014, 2:57 PM

How wearable cameras can help those with Alzheimer's

The wearable camera is being touted as the latest must-have accessory for social-media obsessives, but is a real boon for helping people with serious medical conditions recall important events in their lives.
The Microsoft Research SenseCam has spawned a new generation of technology aimed at tech-savvy twentysomethings.
Some people hang out with their friends on yachts or play pool with pretty girls. Others like to go on treetop zip-wire adventures and holiday on wooded Thai islands. These examples of images on the websites ofAutographer and Narrative Clip, two leading wearable cameras, reveal the kind of things their makers imagine we might do with their devices.
These gadgets automatically snap hundreds of photos per day from their user's perspective. The much-awaited Google Glass, expected to go on general sale within months, will be able to do the same thing. Some believe future historians will peg 2014 as the dawn of the "life-logging" era, in which many or even most of us will carry devices that record images or video of our daily lives.

Beyond the huge privacy implications, the big question is: can this technology improve our lives? For the current market leaders, it is about providing tech-savvy twenty- and thirtysomethings with a way to generate automatically digital photo albums of unprecedented detail and supercharging their social media-sharing capabilities. Some "self-quantifiers" are already using continuous image-gathering as part of personal improvement projects such as losing weight or boosting their productivity.

But such applications are far removed from those envisaged by the technology's early developers, who set out to create visual aids for people with failing memories. And those pioneers may yet be vindicated. Early research suggests that these devices can not only help those with amnesia and dementia recall important events, but may also be able to improve their memory abilities.

One of those innovators was Lyndsay Williams, who probably has the best claim to have been the first to come up with a device capable of taking large numbers of still images automatically. In 1999, shortly after having joined Microsoft Research Cambridge, she attached a digital camera linked to an accelerometer to her bicycle's basket. Her "SenseCam" was designed to take pictures when she was forced to brake hard, in order to capture the details of careless drivers. Williams had temporarily lost six months of memories as a result of being the victim of a hit-and-run road accident aged 17, and she hoped her invention could help others in the same boat. "After that bang on the head I couldn't remember whether I'd been to a concert I had a ticket for or whether I'd done my exams, so I was keenly aware of the frustration of memory difficulties," says Williams, now an independent design consultant. "I also wanted to help a friend who was always losing their keys and their spectacles."

In March 2004, Microsoft filed a patent application for a "recall device" that could help "a victim of Alzheimer's disease and his/her care-giver to reconstruct a portion of the individual's daily activity". Researchers at Addenbrooke's hospital's memory clinic began a collaboration with nearby Microsoft Research in Cambridge to investigate the technology's potential for its patients.

In a case study published in 2007, they revealed that a 63-year-old librarian known as Mrs B, who had amnesia caused by a brain infection, could recall more than 80% of key facts about significant events after a fortnight of reviewing SenseCam images every couple of days and that a similar level of recall persisted for months after she stopped looking at the pictures. This compared with being able to recall just under half of the details using a written diary and no recall at all without either intervention after five days.

Two years later, they published a study in which Mrs B showed increased activity in the parts of the brain linked to experiences associated with time and place, known as episodic memories. They concluded that the device could provide cues that help bring back stored but inaccessible memories, including thoughts, feelings and occurrences not in the images themselves.


Amnesia sufferer Jonathan Eason.

This finding was reinforced by work with Jonathan Eason, a politics student who suffered amnesia, anxiety and depression after being assaulted by two strangers. In the same year, the Addenbrooke's-Microsoft Research group reported that a Mrs W, who had memory problems, was able to recall twice as much detail about events six months old when she viewed streams of SenseCam images over two weeks compared with discussing a written diary for the same amount of time.

The first study involving a number of Alzheimer's patients was published earlier this year by an Addenbrooke's team led by neuropsychologist Dr Emma Woodberry. Six patients with mild to moderate Alzheimer's were able to recall an average of 85% of key factual details about events after a fortnight of viewing SenseCam images every other day. When this was replaced by discussion of a written diary, this fell to 56% and with no intervention it was 33%. Three months later, without any image-viewing, they could still recall an average of just under half of key details, more than three times better than when using a diary.

"Sharing experiences with loved ones is really important to our sense of wellbeing, identity and closeness with the people we love," says Woodberry. "Losing that is debilitating and has a profound effect on your relationships. It's too early to say whether it can slow progression of Alzheimer's, but I think it can improve quality of life in the here and now."

Dr Doug Brown of the Alzheimer's Society believes larger studies are needed. "These findings are interesting but the study is too small to draw any firm conclusions about whether this particular technology is something that we should make widely available to people with dementia, but it's an area that warrants further investigation." His wish could soon be granted: two larger trials are being conducted in France and Portugal.

Others are not only more bullish about the technology's ability to help patients cope day to day, but believe it can have more profound, longer-term effects. A decade ago, Claire, a nurse who lives in Cambridgeshire, awoke from a coma brought on by viral encephalitis, an infection that affects the brain. Then aged 43, she no longer recognised the five people around her bedside as her husband, Ed, and their four children and remembered nothing except some vague childhood memories.

She began using a SenseCam several years ago as part of research led by Dr Catherine Loveday, a cognitive psychologist at the University of Westminster. She uses it most days and views sequences of the images to help her in various situations, such as when she is about to meet a friend. "It can be the oddest little thing in the corner of a picture or somebody's expression that triggers a memory," she says.

"In my friendships, I often feel inadequate because the other person knows about me and the parts of our lives we've shared and I can't remember a single thing about them, their families, or things they might have told me about yesterday. Looking over the images gives me a feeling that I can feel part of our friendship and a tremendous sense of security." Claire is now able to retain recent memories of events as a result of repeated viewings of SenseCam images of them.


'Sometimes, an inventor comes up with the perfect solution but the world isn’t quite ready for it.' Photograph: Katherine Rose for the Observer

Loveday believes pictures from the device help cue recall because they are similar to the snapshots of moments we store and stitch together into narratives to form our natural autobiographical memories. "We think viewing the images in sequence triggers activity in the same brain circuits that were triggered when you first experienced the events and that by doing so repeatedly you can prod the memory into consciousness. I think anyone who has a problem with memory could get a good degree of day-to-day support from using this technology, and, although the evidence is too limited to say for sure at the moment, I think that for some people there is also the possibility that it could lead to recovery of some function."

These encouraging early findings led UK company Vicon Motion to license the technology from Microsoft and launch it in 2010 as the Vicon Revue, a £500 device aimed mainly at people needing memory aids. However, sales were disappointing and it stopped selling the device in 2012. The newer Autographer, marketed more as a visual diary gathering tool, is also based on SenseCam, using sensors to identify action and trigger picture-taking.

Steve Hodges, who leads Microsoft Research Cambridge's sensors and devices group, believes it won't be long before the use of wearable cameras by those with memory loss becomes commonplace.

"Sometimes, an inventor comes up with the perfect solution but the world isn't quite ready for it," he says. "This technology has great deal of potential for those with memory problems and as the devices become more acceptable and commonplace, and they get cheaper and storage and access technologies become more mature, I think we'll see larger trials and more patients using it."

A sufferer's story

Their vows were exchanged beneath a potted maple. The bride wore white and the groom a silver waistcoat and a teal tie. Happy by Pharrell Williams was playing as they left the church.

Jonathan Eason suffers from a form of amnesia that means that even though he was the groom in question, these details of his wedding day at St Ives methodist church, Cambridgeshire in May would all have been lost to him within 24 hours without employing techniques to retain important memories. His use of SenseCam has taught him how to recall things by repeatedly viewing images of them.

"I've lost so many memories and forgetting my wedding day was one of my greatest fears," he says. "It's such a special memory and knowing that it is one I can keep, talk about and share with other people makes me very happy."

Eason, 33, suffered severe head injuries in an unprovoked attack by two strangers while celebrating his 21st birthday in Cambridge. He was about to start his third year studying politics at Queen Mary University of London. The assault left him suffering significant memory impairment, attention problems and anxiety. A subsequent car crash made matters worse, causing low self-esteem, panic attacks, depression and agoraphobia.

Eason first used SenseCam in 2006 as part of a course of treatment devised by experts at the Oliver Zangwell Centre for Neuropsychological Rehabilitation in Ely, Cambridgeshire. Now he uses it alongside note-taking when doing things he wants to remember, such as going on holiday – or getting married. He did not wear the camera during his wedding, but his previous experience of using it taught him how repeatedly viewing the pictures others took would help him retain the memories. He still needs to be accompanied when he goes out, but the device has helped him overcome his social anxiety to the extent that he was able to get married in front of 100 guests, something he wouldn't previously have been able to do.

"Having memory problems can make you inhibited, preventing you from doing new things or even just things that other people consider routine," he says. "But being able to view a record of myself doing things successfully acts as a reminder and has given me more confidence. It has allowed me not only to keep hold of precious memories but also to do normal things like going shopping."


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How Your Hospital Can Overcome the Nursing Shortage and Maximize Profits

by System Administrator - Tuesday, 16 September 2014, 8:46 PM


How Your Hospital Can Overcome the Nursing Shortage and Maximize Profits

Adam Groff Hospitals
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Hybrid Cloud Powers Next Generation Health IT

by System Administrator - Monday, 10 November 2014, 2:30 PM

Hybrid Cloud Powers Next Generation Health IT

The shift from fee-for-service to value-based care is creating significant financial and performance pressures for healthcare providers. As Health IT leaders work to harness cloud, Big Data, mobile, and social technology to optimize their EMR, building a trusted hybrid cloud infrastructure lays the foundation for team-based care.

In this whitepaper, learn how a hybrid cloud framework enables coordinated care to improve patient care delivery, lower IT costs, and increase business agility – including recommended steps and solutions.”

Read this report on the Hybrid Cloud and learn how to:

  • Increase IT capabilities and skill sets while containing costs
  • Meet coordinated care requirements and ensure the right data goes to the right caregiver at the right time

Gain the ability to stretch your IT budget – as you shift capital expenses to operating expenses.

Please download whitepaper.

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