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	<title>HealthRotate</title>
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	<link>http://www.healthrotate.com</link>
	<description>Health 2.0 and Beyond</description>
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		<title>Moments of internal struggle in the ER</title>
		<link>http://www.healthrotate.com/moments-of-internal-struggle-in-the-er/</link>
		<comments>http://www.healthrotate.com/moments-of-internal-struggle-in-the-er/#comments</comments>
		<pubDate>Sun, 05 Sep 2010 19:00:31 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Hospital]]></category>
		<category><![CDATA[Patient Care]]></category>
		<category><![CDATA[UK]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[emergency]]></category>
		<category><![CDATA[hospital]]></category>
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		<guid isPermaLink="false">http://www.healthrotate.com/moments-of-internal-struggle-in-the-er/</guid>
		<description><![CDATA[ by StorytellERdoc, MD I walked into Room 22 to find a very interesting patient who presented to our ER with complaints of abdominal pain and associated nausea and vomiting. The patient sat on her cot with her pant legs rolled up above her knees, refusing, according to her nurse, Gwen, to put on a treatment gown. Her left leg hung in the air, her ankle crossed over the knee of her right leg. Her feet were bare and dirty. Nestled in the crook of her left hip, resting on the cot, was a worn bible, opened to the first page of The Book of Genesis. As Gwen was trying to obtain a better history, the patient was obviously ignoring her, giving all of her attention to the her bible. (...) Read the rest of Moments of internal struggle in the ER No comment &#124; Tags: Emergency , Hospital , Patient &#124; Category: Patient care ]]></description>
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		<title>Acute gonorrhea in Congo</title>
		<link>http://www.healthrotate.com/acute-gonorrhea-in-congo/</link>
		<comments>http://www.healthrotate.com/acute-gonorrhea-in-congo/#comments</comments>
		<pubDate>Sun, 05 Sep 2010 17:00:12 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[MU]]></category>
		<category><![CDATA[VA]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[diagnosis and treatment]]></category>
		<category><![CDATA[patient]]></category>
		<category><![CDATA[primary care]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/acute-gonorrhea-in-congo/</guid>
		<description><![CDATA[ by Yann Meunier, MD Year: 1984 Setting: Ouesso, Congo Position: Timber consortium medical expert We landed in Brazzaville and took a private jet to Pointe Noire where we spent the night. The next day, the group is assigned six 4]]></description>
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		<title>Worth Reading on a Sunday &#8212; Why Social Security Should Be &#8216;Off the Table&#8217;</title>
		<link>http://www.healthrotate.com/worth-reading-on-a-sunday-why-social-security-should-be-off-the-table/</link>
		<comments>http://www.healthrotate.com/worth-reading-on-a-sunday-why-social-security-should-be-off-the-table/#comments</comments>
		<pubDate>Sun, 05 Sep 2010 15:19:37 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[DEA]]></category>
		<category><![CDATA[General]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/worth-reading-on-a-sunday-why-social-security-should-be-off-the-table/</guid>
		<description><![CDATA[ Ezra Klein of the Washington Post makes a key point in his column attacking the idea that raising the retirement age should be part of the solution to the Social Security non-crisis (simply levying Social Security taxees on all income would eliminate the projected deficit). Not everyone is living longer and not everyone has the kind of jobs that they can easily stick with as they age. Life expectancy has increased by four years on average over the past 40 years, but people in the top half of the income distribution saw it go up by six years, while those in the lower half saw it rise by just two years. In other words, increasing the retirement age is just another way of transferring income from poorer people to richer people. Haven't we had enough of that over the past several decades? ]]></description>
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		<title>Wound infections and the Surgical Care Improvement Project (SCIP)</title>
		<link>http://www.healthrotate.com/wound-infections-and-the-surgical-care-improvement-project-scip/</link>
		<comments>http://www.healthrotate.com/wound-infections-and-the-surgical-care-improvement-project-scip/#comments</comments>
		<pubDate>Sun, 05 Sep 2010 15:00:27 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[CMS]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Hospital]]></category>
		<category><![CDATA[Medicaid]]></category>
		<category><![CDATA[NIST]]></category>
		<category><![CDATA[VA]]></category>
		<category><![CDATA[medicare]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[hospital]]></category>
		<category><![CDATA[surgery]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/wound-infections-and-the-surgical-care-improvement-project-scip/</guid>
		<description><![CDATA[ by Skeptical Scalpel, MD The Surgical Care Improvement Project (SCIP) and its antecedent, the Surgical Infection Prevention project, have been around for several years. In short, these consist of several rules issued by various self-appointed agencies with important-sounding names and the Centers for Medicare and Medicaid Services (CMS), a federal agency. The main rules are 1) administer the correct prophylactic antibiotic before surgery, 2) give the antibiotic within one hour before the skin is incised and 3) discontinue the antibiotic within 24 hours of the end of the operation. The stated goal of these initiatives was to reduce the rate of surgical wound infections by 25% by the year 2010. It didn’t happen. (...) Read the rest of Wound infections and the Surgical Care Improvement Project (SCIP) No comment &#124; Tags: Hospital , Specialist , Surgery &#124; Category: Specialist ]]></description>
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		<title>10 top medical blog posts, August 2010</title>
		<link>http://www.healthrotate.com/10-top-medical-blog-posts-august-2010/</link>
		<comments>http://www.healthrotate.com/10-top-medical-blog-posts-august-2010/#comments</comments>
		<pubDate>Sun, 05 Sep 2010 13:00:44 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[Apple]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[DEA]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Hospital]]></category>
		<category><![CDATA[Patients]]></category>
		<category><![CDATA[health it]]></category>
		<category><![CDATA[iPad]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[emergency]]></category>
		<category><![CDATA[hospital]]></category>
		<category><![CDATA[medical potpourri]]></category>
		<category><![CDATA[patient]]></category>
		<category><![CDATA[primary care]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/10-top-medical-blog-posts-august-2010/</guid>
		<description><![CDATA[ Here are the top posts from this past month, based on the number of times they were viewed. 1. Apple’s iPad on medical rounds, a hands on physician review 2. Why primary care is like air traffic control 3. “I’m a patient, not a consumer” 4. Doctors hiring scribes because of electronic medical records 5. Pelvic exam etiquette that doctors need to know 6. Laugh, Sing, and Eat Like a Pig: Facing death, with hope 7. Being a good mother is not about specific mothering choices 8. Missed diagnosis in the ER, and the need to look 9. Notes in the chart are helping patients less 10. 3 tips to stick with an exercise program Health care blog posts of the week, ending August 13, 2010 Being a good mother is not about specific mothering choices 3 tips to stick with an exercise program No comment &#124; Tags: Emergency , Health IT , Hospital , Patient , Primary care &#124; Category: Medical potpourri ]]></description>
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		<title>Are physicians today active in the arts?</title>
		<link>http://www.healthrotate.com/are-physicians-today-active-in-the-arts/</link>
		<comments>http://www.healthrotate.com/are-physicians-today-active-in-the-arts/#comments</comments>
		<pubDate>Sat, 04 Sep 2010 19:00:33 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[AMA]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[Dell]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[HIE]]></category>
		<category><![CDATA[MU]]></category>
		<category><![CDATA[NIST]]></category>
		<category><![CDATA[ONC]]></category>
		<category><![CDATA[Physicians]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[physician practice]]></category>
		<category><![CDATA[physicians]]></category>
		<category><![CDATA[primary care]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/are-physicians-today-active-in-the-arts/</guid>
		<description><![CDATA[ by Jan Henderson, PhD Physician/poets such as William Carlos Williams are an honorable tradition in the history of medicine, following in the footsteps of Keats, Schiller, and Oliver Wendell Holmes (of “Chambered Nautilus” fame). Physicians have also been writers, painters, musicians, philosophers, and – at least in more recent times –photographers. Yet in 1980 the historian G.S. Rousseau expressed concern that modern physicians no longer embodied the humanist tradition of their predecessors. Now that medicine had become overwhelmingly a science rather than an art, he claimed, the interests and accomplishments of physicians had narrowed. In our century nothing has influenced the physician’s profile more profoundly than the loss of his or her identity as the last of the humanists. Until recently, physicians in Western European countries received broad, liberal educations, read languages and literature, studied the arts, were good musicians and amateur painters; by virtue of their financial privilege and class prominence they interacted with statesmen and high-ranking professionals, and continued in these activities through their careers. It was not uncommon, for Victorian and Edwardian doctors, for example, to write prolifically throughout their careers: medical memoirs and auto-biographies, biographies of other doctors, social analyses of their own times, imaginative literature of all types. (...) Read the rest of Are physicians today active in the arts? No comment &#124; Tags: Primary care , Specialist &#124; Category: Physician practice ]]></description>
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		<title>Are opioids any less safe or effective in non cancer patients?</title>
		<link>http://www.healthrotate.com/are-opioids-any-less-safe-or-effective-in-non-cancer-patients/</link>
		<comments>http://www.healthrotate.com/are-opioids-any-less-safe-or-effective-in-non-cancer-patients/#comments</comments>
		<pubDate>Sat, 04 Sep 2010 17:00:17 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[GEM]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Patients]]></category>
		<category><![CDATA[VA]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[drugs]]></category>
		<category><![CDATA[drugs and pharma]]></category>
		<category><![CDATA[gem]]></category>
		<category><![CDATA[patient]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/are-opioids-any-less-safe-or-effective-in-non-cancer-patients/</guid>
		<description><![CDATA[ by Drew Rosielle, MD Recently, the New York Times reported of the movement in Washington State to officially do something about prescription opioid abuse , coming on the heels of course of the FDA rejecting the current risk evaluation and mitigation strategy plan as, essentially, not going far enough. The article basically discusses the discussion in Washington about what to do; no formal new plans have been officially proposed as far as I can tell from the article. (...) Read the rest of Are opioids any less safe or effective in non cancer patients? No comment &#124; Tags: Drugs , Patient &#124; Category: Drugs and pharma ]]></description>
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		<title>Midodrine and Avastin &#8212; Two Very Different Situations</title>
		<link>http://www.healthrotate.com/midodrine-and-avastin-two-very-different-situations/</link>
		<comments>http://www.healthrotate.com/midodrine-and-avastin-two-very-different-situations/#comments</comments>
		<pubDate>Sat, 04 Sep 2010 12:55:05 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[AMA]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[NIST]]></category>
		<category><![CDATA[Patients]]></category>
		<category><![CDATA[VA]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/midodrine-and-avastin-two-very-different-situations/</guid>
		<description><![CDATA[ The Food and Drug Administration pulled an anti-dizziness medication from the market because its sponsor never completed clinical trials necessary to show it actually worked. Users of midodrine, which had been approved under the accelerated approval program in 1996, flooded the agency with protests, according to this morning's New York Times . The agency backtracked. The story noted "in a similar case" that the FDA is considering "whether to withdraw its approval for the use of Avastin, a cancer medicine made by Genentech, for breast cancer. Recent clinical trials failed to prove that Avastin was helpful in treating breast cancer, but patients and some in Congress expressed outrage that the agency could withdraw approval for the use, an action that could lead insurers to stop paying for it." These are not similar cases. The midodrine trials have never been done. There is no evidence one way or the other as to its effectiveness (other than the preliminary data that led to accelerated approval). Therefore, anecdotal information from patients (and when it comes to dizziness, I would think the placebo effect would be a powerful force) is all the agency has to go by. Its withdrawal appears to have been an attempt to crack down on companies that refuse to conduct final clinical trials (in this case, because they were largely generic; near the end of the story, Shire, the original sponsor, said it would eventually complete the trials). Genentech, on the other hand, did its job. It completed the two clinical trials required after Avastin won accelerated approval for advanced metastatic breast cancer (it has full approval for other cancers). Those trials were designed to show if delaying tumor progression briefly (the results that led to accelerated approval) actually delayed mortality. It did not. So, unlike midodrine, the science is clear. As I said in a previous post, the FDA will jeopardize its reputation if it ignores that outcome (and the advice of an advisory committee). The colleteral damage: it will embolden every patient advocacy group wielding anecdotal patient-reported outcomes, who will be able to say (with some justification) "you did it for Avastin, why not X?" ]]></description>
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		<title>EMR Consulting Business Model</title>
		<link>http://www.healthrotate.com/emr-consulting-business-model/</link>
		<comments>http://www.healthrotate.com/emr-consulting-business-model/#comments</comments>
		<pubDate>Fri, 03 Sep 2010 23:30:02 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[EHR]]></category>
		<category><![CDATA[EHR Consultant]]></category>
		<category><![CDATA[EHR Consulting]]></category>
		<category><![CDATA[EMR]]></category>
		<category><![CDATA[EMR Consultant]]></category>
		<category><![CDATA[EMR Consulting]]></category>
		<category><![CDATA[Electronic Health Record]]></category>
		<category><![CDATA[HealthCare IT]]></category>
		<category><![CDATA[2010]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[ehr consultant]]></category>
		<category><![CDATA[EMR Sales]]></category>
		<category><![CDATA[EMR training]]></category>
		<category><![CDATA[ERP]]></category>
		<category><![CDATA[HIPAA]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/emr-consulting-business-model/</guid>
		<description><![CDATA[ I&#8217;ve been thinking about the EMR consulting business model for a long time (check out my first post on EMR consulting back on October 27, 2006). My personal career path has taken me a different direction. I do some occasional consulting for people, but it&#8217;s not really my core business. Unfortunately, I don&#8217;t scale very well. With that said, I think there&#8217;s definitely a business model for a company that does EMR consulting. In fact, today I learned that one of my advertisers and also an EMR consulting company, Enterprise Software Development, was ranked #561 out of the 5000 fastest growing companies in America (see press release ). That&#8217;s right. I guess EMR consulting is a good enough business that they can use an EMR consulting business to become one of the fast growing American companies. Plus, I agree with the press release that this next year we&#8217;re likely to see EMR consulting grow even more. While I ABHOR EMR sales people who like to call themselves EMR consultants, I think there&#8217;s definitely a place in the EMR industry for qualified EMR consultants. In fact, check out this series of EMR consultant posts where I talk about the possible advantages of using an EMR consultant: Benefits of Using an EMR/EHR Consultant &#8211; Selection Process Benefits of Using an EMR/EHR Consultant &#8211; EMR Training Benefits of Using an EMR/EHR Consultant &#8211; Clinical Process Mapping Benefits of Using an EMR/EHR Consultant &#8211; Comprehensive Technology Support Benefits of Using an EMR/EHR Consultant &#8211; Improved Clinical Buy-in NOTE: I wrote all these in early 2008. I don&#8217;t think too much has changed since then. Although, there are likely more EMR consultant opportunities . Related posts: My EMR Consulting Business Plan I know I&#8217;ve talked about being an EMR consultant, but... Possible REC Business Model As I said before, I&#8217;m finding the EHR RECs very... Quoted in an Article on EMR Consulting I want to thank Selena Chavis for writing a good... ]]></description>
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		<title>Health care reform provides a chance that we can do the right thing</title>
		<link>http://www.healthrotate.com/health-care-reform-provides-a-chance-that-we-can-do-the-right-thing/</link>
		<comments>http://www.healthrotate.com/health-care-reform-provides-a-chance-that-we-can-do-the-right-thing/#comments</comments>
		<pubDate>Fri, 03 Sep 2010 19:00:36 +0000</pubDate>
		<dc:creator>HealthRotate</dc:creator>
				<category><![CDATA[2010]]></category>
		<category><![CDATA[CES]]></category>
		<category><![CDATA[DEA]]></category>
		<category><![CDATA[General]]></category>
		<category><![CDATA[Hospital]]></category>
		<category><![CDATA[MT]]></category>
		<category><![CDATA[MU]]></category>
		<category><![CDATA[VA]]></category>
		<category><![CDATA[twitter]]></category>
		<category><![CDATA[health reform]]></category>
		<category><![CDATA[hospital]]></category>

		<guid isPermaLink="false">http://www.healthrotate.com/health-care-reform-provides-a-chance-that-we-can-do-the-right-thing/</guid>
		<description><![CDATA[ by Joe Flower The rapidly ramifying crisis in health care may (we can pray) end all delusions. It may at least begin to weaken them by exposing them to the light, to the sobering effects of reality. The reform act has not brought us to the Promised Land. By bringing us access without capacity, fierce restrictions coupled with vague language and loopholes, mandates coupled with fines low enough to become the cheap way out, strong new ideas that are only pilots, and tough commissions and task forces that have no teeth, the reform act delivers us into a period of maximum melee, in which the needs and desires of hospitals, doctors, citizens, politicians, insurers, drug companies, device manufacturers and hundreds to thousands of niche industries within the sector, get pitted nakedly against one another. (...) Read the rest of Health care reform provides a chance that we can do the right thing No comment &#124; Tags: Health reform &#124; Category: Health policy and politics ]]></description>
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