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Nearly three-quarters of prescription-takers use mobile apps, including most older adults and seniors

Nearly three-quarters of prescription-takers use mobile apps, including most older adults and seniors | Vancouver Island Physicians | Scoop.it

Most patients taking prescription medicine (72%) also use mobile apps (Android smartphone, iPhone, Android tablet, iPad, or Kindle Fire),

Mobile app adoption rates are high across all medication-taking adult age groups: 93% (age 18-24), 90% (age 25-34), 88% (age 35-44), 80% (age 45-54), 66% (age 55-64), and 50% (age 65+),

App-using patients prefer the privacy-protected single app Mobile Health Library (MHL) system (by a factor of 11 to 1) over email programs often offered by medication manufacturers.  This high preference for a privacy-protected single app, customized to a user's needs for medication education and support services, was observed across all adult age groups.


Via Alex Butler
Dr Martin Wale's insight:

I've not been able to verify the funding source for this research, so it could just be marketing.  If you know, please comment.  Thanks!

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NHS wasting £450m on 'mid-life MOT' health checks, doctors say

NHS wasting £450m on 'mid-life MOT' health checks, doctors say | Vancouver Island Physicians | Scoop.it
Three leading medics say the checks for over-40s have prevented as few as 1,000 deaths a year at a cost to the NHS of about £450,000 each The NHS is wasting £450m a year on health checks for 40-74-year-olds because they often fail to spot that...
Dr Martin Wale's insight:

Another view from the UK.  ["MOT" refers to periodic mandatory roadworthiness tests on older cars.]

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Crowdfunding offers medical patients and researchers chance but no guarantees ... - Buffalo News

Crowdfunding offers medical patients and researchers chance but no guarantees ... - Buffalo News | Vancouver Island Physicians | Scoop.it
After his hometown visit to Attica, Airman Michael Romanyak headed back to Barksdale Air Force Base near Shreveport, La., when the horrifying crash happened on July 1.
Dr Martin Wale's insight:

Another topic about which there is much hype.  This has some useful examples.

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BMJ Careers - Medical schools overuse simulation technology, says leading academic

"I think we need to challenge the colonisation of medical education by the unreal: the simulated patient, the silicone body part, the standardised scenario, the objective and structured (but entirely fictitious) clinical examinations."  Trish Greenhalgh, speaking at the UK Royal College of GPs.

Dr Martin Wale's insight:

Simulation is often seen as an answer to boosting technical skills without the ethical and practical difficulties of working with real patients.  However, good physicians are not merely competent technicians, and building relationships with patients is a key factor in providing a good patient experience. We can't neglect the soft skills.

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The best thing about being a doctor is sharing the secrets of the NHS system

The best thing about being a doctor is sharing the secrets of the NHS system | Vancouver Island Physicians | Scoop.it
I see where the health service fails patients and I want to apologise for itThere are so many excellent aspects of being a doctor you may think it difficult to pick the best one. The good news is I have the answer.
Dr Martin Wale's insight:

Refreshingly honest yet disturbing, and probably no less true in Canada.  The very best thing about being a doctor is knowing how to navigate the system.

So how do we make this expert knowledge available to our patients?

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Addressing a shortage of family physicians

Addressing a shortage of family physicians | Vancouver Island Physicians | Scoop.it
VICTORIA - CTV News Vancouver Island looks at what's being done to make sure a family physician will be available when you need one.
Dr Martin Wale's insight:

Star cast in this video clip about the Island Medical Program.  (Sorry about the advert at the beginning.)

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Professional Help: A compassionate response (with video)

Professional Help: A compassionate response (with video) | Vancouver Island Physicians | Scoop.it
“Just sit there and wait. Don’t you know there are real sick people here?”
Dr Martin Wale's insight:

Congratulations and thanks to Fraser Health for producing this video, and Kelly Reid for drawing it to my attention.  It's often the small interpersonal contacts that make the biggest impact, and the difference between care and mere treatment.

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The misery of measles in a world without vaccines

The misery of measles in a world without vaccines | Vancouver Island Physicians | Scoop.it
Before the introduction of the MMR shots, measles killed hundreds of Canadians a year
Dr Martin Wale's insight:

Thanks to Dr. Frank Jagdis, an ID physician here in Victoria BC, for the local focus in this story.

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The Canadian Consortium for the Investigation of Cannabinoids (CCIC) | The Canadian Consortium for the Investigation of Cannabinoids (CCIC) Launches First-Ever Medical Cannabis Podcast Series

"We hope to reach physicians & patients interested in learning about medical cannabis" - @CannTrust launches podcast http://t.co/B3Zox6VE6w
Dr Martin Wale's insight:

For those interested in medical cannabis.

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Anti-Vaxxers: Enjoying the Privilege of Putting Everyone at Risk

Anti-Vaxxers: Enjoying the Privilege of Putting Everyone at Risk | Vancouver Island Physicians | Scoop.it

The most destructive vision of privilege: in your house, all the bad things might be fatal — whereas in my house they're just optional.

Dr Martin Wale's insight:

Well-written and incisive piece about the privileged anti-vaccine crowd.  From Rolling Stone, with thanks to Andre Picard.

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Medical-fax probe findings not released - Times Colonist

Medical-fax probe findings not released - Times Colonist | Vancouver Island Physicians | Scoop.it
A seven-week investigation into privacy breaches that saw more than 200 pages of sensitive medical information faxed to a Victoria woman’s home has wrapped up, but the Office of the Information and. .
Dr Martin Wale's insight:

The real issue here is that we need stop faxing and use something more secure - like secure end-to-end email (assured sender, assured recipient, and information encrypted in transit).  It's not difficult really.

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Hippie science is easy, and wrong - Nanaimo News Bulletin (and other sources)

Hippie science is easy, and wrong - Nanaimo News Bulletin (and other sources) | Vancouver Island Physicians | Scoop.it

Debunking detox!

Dr Martin Wale's insight:

Insightful and entertaining - well done Tom Fletcher!

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BMJ Careers - Something is profoundly wrong with the NHS today

The health service’s prevailing culture is one of fear, even though its staff are meant to espouse kindness and compassion. The service is becoming a place where staff feel attacked, unloved, and abandoned by their political and managerial leaders."


"Surveys have shown that the main concern of NHS trust finance directors is staff morale, ahead of waiting time targets or patient experience.[3] For doctors and nurses, high rates of mental illness, emigration, whistleblowing, suspensions, referrals to the regulator, and complaints all point to a system in serious trouble.

Dr Martin Wale's insight:

Utterly chilling analysis of the current state of the English NHS, from Clare Gerada, medical director of the Practitioner Health Programme, a confidential London based health service for doctors and dentists.

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Measures will give cancer patients vital information - Montreal Gazette

Measures will give cancer patients vital information - Montreal Gazette | Vancouver Island Physicians | Scoop.it
Quebec cancer hospitals are facing a major overhaul in the way they handle cancer cases, aimed at putting the patient and the family at "the heart of decisions" of tumour boards, the teams of exper...
Dr Martin Wale's insight:

Interesting snapshot of what seems a remote and paternalistic system.

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Victoria's family doctor shortage reaching desperate levels, physician says - CTV Vancouver Island

Victoria's family doctor shortage reaching desperate levels, physician says - CTV Vancouver Island | Vancouver Island Physicians | Scoop.it
Long-time family doctor William Cavers says demand from patients is skyrocketing at a time when general practitioners are in short supply.
Dr Martin Wale's insight:

Sadly, this is not a local phenomenon - general practice in the UK is also under huge pressure.

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30 Minutes to Save a Life: Doc Uses Social Network to Diagnose Fatal Condition

30 Minutes to Save a Life: Doc Uses Social Network to Diagnose Fatal Condition | Vancouver Island Physicians | Scoop.it

ust three weeks ago a doctor on SERMO, the top growing global social network of more than 340,000 doctors, saved a boy's life through medical crowdsourcing. This disruptive new healthcare phenomenon enables doctors to pool their collective wisdom online to solve tough patient cases and save lives.

When a 14 year-old boy visited the physician's office with a persistent cough, the primary care physician ran all the standard tests – yet everything came back normal. When the boy returned for a follow-up, he reported feeling better after coughing up a strange looking "branch-like" mass, which his mother brought with him to show the doctor.

Before sending the unusual specimen to the lab, the doctor snapped a picture and posted it on SERMO to crowdsource insights from colleagues and specialists. He also created a poll listing multiple diagnoses. Within 30 minutes, the first doctor responded to the community post and poll and over the next two days, 231 doctors from the US and UK weighed in with 16 possible diagnoses for the coughed-up branch.

Within a few hours, one cardiologist nailed it: Fontan-Associated Plastic Bronchitis, an extremely rare respiratory condition associated with previous heart surgeries that few primary care doctors will ever encounter.

"While pulmonary may help, he needs to see cardiology urgently for plastic bronchitis following Fontan surgeries… please give them a call and ask whoever is on call for the weekend when they can see him (or have him admitted)." – Cardiologist

A pediatrician with pulmonology and respiratory expertise confirmed this observation:

"I agree that this is very concerning for plastic bronchitis. We see this very frequently in our hospital especially in patients with congenital heart disease… I agree with [the first to diagnose plastic bronchitis] that he should be seen by cardiology ASAP."

Another doctor linked to a related post in which a child, who went undiagnosed with the same condition, died:

"[I had] a little 3 year old patient of mine who died from this recently. Mother had shown her doctors a cast she had coughed up while in the hospital for respiratory symptoms post Fontan, but sent her home without recognizing the diagnosis. She died a few days later."

Without waiting for results to come back from the lab, the child's primary care physician referred the patient to cardiology. In just two days, the cardiologists treated the boy and saved his life.

As medicine becomes increasingly specialized, and with 13,000 known medical conditions, no individual doctor can diagnose all conditions across all specialties based on their personal training and knowledge alone. In a recent international SERMO poll conducted in the UK, US, France, Spain, Italy and Germany, the majority of doctors (up to 87 percent) stated that at least 20 percent of patient cases fell in the medical "grey zone," where doctors believe they would benefit from input from a broader range of doctors. Rare conditions like the one the boy presented with, are particularly challenging.

On SERMO, doctors regularly benefit from the power of medical crowdsourcing to address the "grey zone." Over the course of 2014, doctors posted 3,500 challenging patient cases on the social network, which were viewed a total of 700,000 times and received 50,000 comments. On SERMO, most doctors receive responses from peers around the country and soon around the world within 1.5 hours and solve cases within 24 hours.

According to the US National Center on Policy Analysis, each year, 10 to 20 percent of cases are misdiagnosed; 28 percent of those diagnostic mistakes are life-threatening; and, as many as 40,000 people die from fatal diagnostic errors in U.S. intensive care units.

"Many treatable conditions go mis- or undiagnosed for years not for a lack of science, but simply because doctors traditionally do not have quick access to a network of specialists who can quickly recognize potential red flags of challenging conditions," said Dr. Richard Armstrong a SERMO member and general surgeon. "Medical crowdsourcing has the power to change that, giving doctors around the world free access to the best collective medical expertise at the tip of their fingertips."

"Medical crowdsourcing fills a huge void in healthcare today and is transforming the way doctors practice everyday medicine," said Dr.Easton Jackson, a SERMO member and the physician who treated the patient. "Now, in real-time, doctors can access hundreds of years of combined medical education at the push of a button to get faster – sometimes life-saving – diagnoses."

Medical crowdsourcing works particularly well on SERMO versus other social networks because of the very large number of doctors on the site and the fact that all members are verified physicians.

Anonymity on SERMO is also a key aspect to doctors acting quickly and weighing in on tough cases. In a doctor-only environment, anonymity is the hallmark of SERMO and what makes it unique compared to other identified doctor networks. It is essential that doctors feel that they are safe to voice their opinions and to seek and give clinical input from their peers without fear of repercussions.

"Having the ability to access insights from my colleagues safely and securely – in a closed, doctors-only environment that also maintains patient privacy – is critical and certainly played a central role in making the diagnosis in time and saving this young child's life," said Dr. Jackson.



Via Plus91
Dr Martin Wale's insight:

Interesting and compelling story of the clear benefits of "medical crowdsourcing".  If anyone has had a similar experience please let us know.


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The danger to online health seekers

The danger to online health seekers | Vancouver Island Physicians | Scoop.it

POST SUMMARY: According to the Pew Internet Project, 72 percent of US internet users look up health-related information online. But an astonishing number of the pages we visit to learn about private health concerns—confidentially, we assume—are tracking our queries, sending the sensitive data to third party corporations, even shipping the information directly to the same brokers who monitor our credit scores. It’s happening for profit, for an “improved user experience,” and because developers have flocked to “free” plugins and tools provided by data-vacuuming companies.

In April 2014, Tim Libert, a researcher at the University of Pennsylvania, custom-built software calledwebXray to analyze the top 50 search results for nearly 2,000 common diseases (over 80,000 pages total). He found the results startling: a full 91 percent of the pages made what are known as third-party requests to outside companies. That means when you search for “cold sores,” for instance, and click the highly ranked “Cold Sores Topic Overview WebMD” link, the website is passing your request for information about the disease along to one or more (and often many, many more) other corporations.

According to Libert’s research, which is published in the Communications of the ACM, about 70 percent of the time, the data transmitted “contained information exposing specific conditions, treatments, and diseases.” That, he says, is “potentially putting user privacy at risk.” And it means you’ll probably want to think twice before looking up medical information on the internet.

This puts users are risk for two significant reasons: first, people’s health interests may be publicly identified along with their names. This could happen because criminals get a hold of the information, it is accidentally leaked, or data brokers collect and sell the information. Second, many online marketers use algorithmic tools which automatically cluster people into groups with names like “target” and “waste.” Predictably, those in the “target” category are extended favorable discounts at retailers and advance notice of sales. Given that 62 percent of bankruptcies are the result of medical expenses, it is possible anyone visiting medical websites may be grouped into the “waste” category and denied favorable offers.

Personal health information — historically protected by the Hippocratic Oath — has suddenly become the property of private corporations who may sell it to the highest bidder or accidentally misuse it to discriminate against the ill,” Libert said. “As health information seeking has moved online, the privacy of a doctor’s office has been traded in for the silent intrusion of behavioral tracking.”

Online privacy has for some time been a concern. Studies conducted by Annenberg dating back to 1999 indicate wariness among Americans about how their personal information may be used. And slightly more than one in every three Americans even knows that private third-parties can track their visits to health-related websites.



Via Plus91
Dr Martin Wale's insight:

Interesting and troubling account of the perils of searching for health information on line. It's probably safe to assume that information about what you're searching for, or even contact information is being collected for sale or marketing.

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Measles cases haven’t swayed Canadian anti-vaxxers, survey finds

Measles cases haven’t swayed Canadian anti-vaxxers, survey finds | Vancouver Island Physicians | Scoop.it
Sixty-five per cent of respondents cited health concerns as the reason their child hadn’t been vaccinated, while 19 per cent said it was because of their religious beliefs
Dr Martin Wale's insight:

Deeply sad but not surprising.  It's a gut reaction, not a rational one, so no amount of evidence is likely to work. Changing minds needs an emotional connection.

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Ontario Medical College Adopts New Rule Saying Doctors May Not Refuse Service on Moral or Religious Grounds

Ontario Medical College Adopts New Rule Saying Doctors May Not Refuse Service on Moral or Religious Grounds | Vancouver Island Physicians | Scoop.it
Last year, in Canada,
[D]octors in two major cities made national headlines by denying medical care based on... http://t.co/EL4d2thgeF
Dr Martin Wale's insight:

Striking a sensible balance to ensure patients receive timely care.  Physicians with moral or religious objections to providing particular types of care should consider their position in advance and plan to redirect these patients, and not simply refuse to treat.

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5 ways robots are delivering health care in Saskatchewan

5 ways robots are delivering health care in Saskatchewan | Vancouver Island Physicians | Scoop.it
In a province where patients often travel long distances and wait long periods of time to see a specialist, Dr. Ivar Mendez predicts remote-presence technology will deliver care closer to home.
Dr Martin Wale's insight:

Not sure that purists would call these robots, but remote telepresence technology is providing better care in isolated situations than would otherwise be achievable.

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Amid measles outbreaks, WHO calls for more vaccinations in Europe

Amid measles outbreaks, WHO calls for more vaccinations in Europe | Vancouver Island Physicians | Scoop.it
UN agency has recorded 22,000 cases of the highly infectious disease since the start of 2014
Dr Martin Wale's insight:

The CDC estimates that measles vaccination prevented 13.8 million deaths in 2012-13 compared with no vaccination - but the figure which really startled me was the WHO report of 145,700 measles deaths worldwide in 2013.  This is nuts - it's been preventable for 50 years.

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Expanded services to test people for blood-borne diseases - Campbell River Mirror

Expanded services to test people for blood-borne diseases - Campbell River Mirror | Vancouver Island Physicians | Scoop.it
More testing and prevention available now for those living with or at risk of contracting AIDS or HIV
Dr Martin Wale's insight:

Important initiative.  Curiosity didn't kill the cat, ignorance did.

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Trevor Hancock: To die a healthy death is not an oxymoron - Times Colonist

Trevor Hancock: To die a healthy death is not an oxymoron - Times Colonist | Vancouver Island Physicians | Scoop.it
For years, as part of my health-promotion courses, I have introduced the idea of “healthy death.” The initial reaction, not surprisingly, is that this makes no sense; it’s an oxymoron. So then I . . .
Dr Martin Wale's insight:

Well reasoned and rational - the health promotion approach to dying with dignity and in physical/mental/spiritual comfort.

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Measles Outbreak: Pediatricians Refuse Unvaccinated Children To Combat Anti ... - International Business Times

Measles Outbreak: Pediatricians Refuse Unvaccinated Children To Combat Anti ... - International Business Times | Vancouver Island Physicians | Scoop.it
To safeguard their waiting rooms, a growing number of pediatricians are refusing to treat unvaccinated children during the current measles outbreak.
Dr Martin Wale's insight:

Interesting development.  It suggests that there may be utility in cohorting unvaccinated children in their health system interactions.

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Doctors Want Employment, Not Marcus Welby Life - Forbes

Doctors Want Employment, Not Marcus Welby Life - Forbes | Vancouver Island Physicians | Scoop.it
Very few young doctors are interested in starting their own “solo practice” anymore, preferring to become employees of a larger group, hospital and even working for the government, two different physician recruitment studies out this week indicate.
Dr Martin Wale's insight:

In the US, the tide seems to be going out on the traditional business model for physicians.  

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Physicians are treating the well, and nurses are treating the sick

Physicians are treating the well, and nurses are treating the sick | Vancouver Island Physicians | Scoop.it
Perhaps doctors should be handling more of the sick-call, and nurse practitioners more of the maintenance of modern health care.

Via Technical Dr. Inc.
Dr Martin Wale's insight:

"A Country Doctor" takes aim at the paradox of the least experienced clinicians taking on those situations where maximum diagnostic acumen is required, because the most experienced are fully occupied with care of chronic diseases.

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