Our practice has been using Vista / CPRS "WorldVista" for a couple years now. And we are now in the process of switching to something else because - we cannot get Vista to meet federal meaningful use requirements. - we cannot get adequate tech support to tailor the system to our practice.
And note that while is it public domain, you still need an entity to install it, train your office staff, run servers, etc.
It was far from free. Indeed, now purchasing our second "EHR" has made it an even more costly mistake.
The circulating nurses in my OR are excellent at being circulating nurses, not at being CT scan navigators. It is quite painful to watch a nurse "scroll down to that inflammatory process in the right lower quadrant". It is a task that would take me 1-2 seconds with a mouse, but takes seemingly an eternity for someone not accustomed to interpreting CT scans.
Trust me, moving that task to the surgeon would not come CLOSE to eliminating the job of the circulating nurse. The vast majority of their job has nothing to do with navigating radiographs. But it would speed up the operation (good) and make things MUCH less frustrating for the surgeon (also good).
It's interesting to stop and think what the doctor who takes out your appendix earns in an hour. If it happens to be an uncomplicated operation, an appendectomy might take me 45min best case. It could take 2 hours. I would say it takes at least an hour (at shortest) before the operation starts to examine / interview the patient, get informed consent, evaluate labs, imaging studies. Then there is postoperative care of the patient in the hospital as well as follow-up visits to the clinic later.
As a surgeon, Medicare reimburses a $482.62 "global fee" for a laparoscopic appendectomy in my area (there are no provisions for charging "by the hour.". So it's tough to say how much I make in an hour. But I'd say it is safely below these "reasonable attorney's fees." Not to whine here. I'm not starving.
And FYI, after high school: 4yrs undergrad, 4 yrs med school, 5 yrs surgical residency.
I wonder how confortable Dell employees feel about their retirement plans? There is no shortage of companies who have recently bricked the value of the company plans and left thousands of people high and dry.
I'd be considering ways to move the value of my retirement plan somewhere else.
Perhaps I am ignorant. (I certainly have not meant this to be personal.) But I disagree that the study is poorly planned. That is why we have institutional review boards.
There is a very good reason why life expectancy in this country has increased from the 30's to the 70's in less than a century. A huge reason is that children now more often survive childhood.
The subjects have no choice? Aren't we talking about children? The *parents* make these choices. You seem to say that since ignorant parents exist, we should not continue any research involving children. I say you are being shortsighted. How do you intend for us to further science at all? By banning research?
From the article: Cox and Baumgartner have permission to recruit 10 head injury patients to the study between the ages of 5 and 14 who meet criteria set for enrollment.
Children of these ages are not the "stem cell factories" than you describe. These are not babies.
All of her healing was without the use of any stem cell treatment, because babies are stem cell factories. Her same injuries would have killed an adult, several times over.
So studies to further the efficacious use of stem cells in older children and adults should not be done? There is a flaw in your logic.
about how they would use GPSr's to measure *seafloor* movement. Is this thing submerged and anchored to the floor of the ocean? Or is it a buoy with an umbilical to something fixxed to the seafloor? Or is it a buoy that simply floats and measures at the surface only?
I'm sure they have considered it, but I don't see it in the article.
From TFA: One plan is to build a full-scale version of the planned Mars settlement and charge visitors to tour the "Mars Settlement Research and Outreach Center." 4Frontiers hopes to have a site selected for the center by the end of this year, said company co-founder and CEO Mark Homnick.
This is one big BS hype storm for their cheesy theme park.
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Our practice has been using Vista / CPRS "WorldVista" for a couple years now. And we are now in the process of switching to something else because
- we cannot get Vista to meet federal meaningful use requirements.
- we cannot get adequate tech support to tailor the system to our practice.
And note that while is it public domain, you still need an entity to install it, train your office staff, run servers, etc.
It was far from free. Indeed, now purchasing our second "EHR" has made it an even more costly mistake.
The circulating nurses in my OR are excellent at being circulating nurses, not at being CT scan navigators. It is quite painful to watch a nurse "scroll down to that inflammatory process in the right lower quadrant". It is a task that would take me 1-2 seconds with a mouse, but takes seemingly an eternity for someone not accustomed to interpreting CT scans.
Trust me, moving that task to the surgeon would not come CLOSE to eliminating the job of the circulating nurse. The vast majority of their job has nothing to do with navigating radiographs. But it would speed up the operation (good) and make things MUCH less frustrating for the surgeon (also good).
As a surgeon, Medicare reimburses a $482.62 "global fee" for a laparoscopic appendectomy in my area (there are no provisions for charging "by the hour.". So it's tough to say how much I make in an hour. But I'd say it is safely below these "reasonable attorney's fees." Not to whine here. I'm not starving.
And FYI, after high school: 4yrs undergrad, 4 yrs med school, 5 yrs surgical residency.
I wonder how confortable Dell employees feel about their retirement plans? There is no shortage of companies who have recently bricked the value of the company plans and left thousands of people high and dry.
I'd be considering ways to move the value of my retirement plan somewhere else.
Perhaps I am ignorant. (I certainly have not meant this to be personal.) But I disagree that the study is poorly planned. That is why we have institutional review boards.
There is a very good reason why life expectancy in this country has increased from the 30's to the 70's in less than a century. A huge reason is that children now more often survive childhood.
The subjects have no choice? Aren't we talking about children? The *parents* make these choices. You seem to say that since ignorant parents exist, we should not continue any research involving children. I say you are being shortsighted. How do you intend for us to further science at all? By banning research?
What should be the larger ethical concern is that these children don't have the maturity to measure the consequences of this treatment,
By your reasoning, no medical research at all should done if it involves children. Since they can't understand it.
nor the legal authority to give permission for this treatment.
By your reasoning, we shouldn't "force" insulin on kids with type I diabetes. Since they are too young to legally consent.
From the article: Cox and Baumgartner have permission to recruit 10 head injury patients to the study between the ages of 5 and 14 who meet criteria set for enrollment.
Children of these ages are not the "stem cell factories" than you describe. These are not babies.
All of her healing was without the use of any stem cell treatment, because babies are stem cell factories. Her same injuries would have killed an adult, several times over.
So studies to further the efficacious use of stem cells in older children and adults should not be done? There is a flaw in your logic.
about how they would use GPSr's to measure *seafloor* movement. Is this thing submerged and anchored to the floor of the ocean? Or is it a buoy with an umbilical to something fixxed to the seafloor? Or is it a buoy that simply floats and measures at the surface only?
I'm sure they have considered it, but I don't see it in the article.
Well, for one welcome our new invertebrate overlords. . .
From TFA:
One plan is to build a full-scale version of the planned Mars settlement and charge visitors to tour the "Mars Settlement Research and Outreach Center." 4Frontiers hopes to have a site selected for the center by the end of this year, said company co-founder and CEO Mark Homnick.
This is one big BS hype storm for their cheesy theme park.