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  1. Last 7 days
    1. The assassination is a koan that brings to light the paradox at the heart of civilisation: what’s real is our experience of being alive, not how we can be quantified, but we pretend the opposite is true.

      for - comparison - symbolosphere vs physiosphere - assassination of United Healthcare CEO Brian Thompson - Substack article - Best Served Cold: Luigi Mangione and The Age of Breach - Alexander Beiner

  2. Oct 2024
  3. Sep 2024
    1. Phone: (417) 269-2160

      Often you'll be unable to get a situation resolved calling the Clinic. Instead call… CoxHealth Customer Experience (417) 269-6101

    2. Often you'll be unable to get a situation resolved calling the Clinic. Instead call... CoxHealth Customer Experience (417) 269-6101

  4. Sep 2023
    1. Kid-friendly gummies

      Cureka is an online store for finding doctors approved healthcare products including healthcare devices, dietary health supplements, pain management equipment, wellness products, herbal ayurveda products, hair care products, skincare, and baby care products. The website was founded in 2016 that helped millions of people to take care of their health.

    1. To build HIPAA compliant software, developers need to be aware of and comply with several key requirements outlined in the HIPAA Privacy Rule and Security Rule. These requirements are designed to ensure the confidentiality, integrity, and availability of protected health information (PHI) and to prevent unauthorized access, use, or disclosure of PHI.

      Building software compliant with HIPAA standards necessitates a deep understanding of its Privacy and Security Rules to safeguard protected health information effectively.

  5. May 2023
    1. HL7 integration helps enable medical data standardization, assisting hospitals in achieving their primary goals. In this post, you will discover what HL7 standards are, how they work, and how to integrate them.

      WHAT IS HL7 INTEGRATION?

  6. Apr 2023
    1. This is the space where AI can thrive, tirelessly processing these countless features of every patient I’ve ever treated, and every other patient treated by every other physician, giving us deep, vast insights. AI can help do this eventually, but it will first need to ingest millions of patient data sets that include those many features, the things the patients did (like take a specific medication), and the outcome.

      AI tools yes, not ChatGPT though. More contextualising and specialisation needed. And I'd add the notion that AI might be necessary as temporary fix, on our way to statistics. Its power is in weighing (literally) many more different factors then we could statistically figure out, also because of interdependencies between factors. Once that's done there may well be a path to less blackbox tooling like ML/DL towards logistic regression: https://pubmed.ncbi.nlm.nih.gov/33208887/ [[Machine learning niet beter dan Regressie 20201209145001]]

    2. My fear is that countless people are already using ChatGPT to medically diagnose themselves rather than see a physician. If my patient in this case had done that, ChatGPT’s response could have killed her.

      More ELIZA. The opposite of searching on the internet for your symptoms and ending up with selfdiagnosing yourself with 'everything' as all outliers are there too (availability bias), doing so through prompting generative AI will result in never suggesting outliers because it will stick to dominant scripted situations (see the vignettes quote earlier) and it won't deviate from your prompts.

    3. If my patient notes don’t include a question I haven’t yet asked, ChatGPT’s output will encourage me to keep missing that question. Like with my young female patient who didn’t know she was pregnant. If a possible ectopic pregnancy had not immediately occurred to me, ChatGPT would have kept enforcing that omission, only reflecting back to me the things I thought were obvious — enthusiastically validating my bias like the world’s most dangerous yes-man.

      Things missing in a prompt will not result from a prompt. This may reinforce one's own blind spots / omissions, lowering the probability of an intuitive leap to other possibilities. The machine helps you search under the light you switched on with your prompt. Regardless of whether you're searching in the right place.

    4. My experiment illustrated how the vast majority of any medical encounter is figuring out the correct patient narrative. If someone comes into my ER saying their wrist hurts, but not due to any recent accident, it could be a psychosomatic reaction after the patient’s grandson fell down, or it could be due to a sexually transmitted disease, or something else entirely. The art of medicine is extracting all the necessary information required to create the right narrative.

      This is where complexity comes in, teasing out narratives and recombine them into probes, probing actions that may changes the weights of narratives and mental models held about a situation. Not diagnostics, but building the path towards diagnostics. Vgl [[Probe proberend handelen 20201111162752]] [[Vertelpunt 20201111170556]]

    5. This is likely why ChatGPT “passed” the case vignettes in the Medical Licensing Exam. Not because it’s “smart,” but because the classic cases in the exam have a deterministic answer that already exists in its database.

      Machines will do well in scripted situations (in itself a form of automation / codification). This was a factor in Hzap 08 / 09 in Rotterdam, where in programming courses the problems were simplified and highly scripted to enable the teacher to be able to grade the results, but at the cost of removing students from actual real life programming challenges they might encounter. It's a form of greedy reductionism of complexity. Whereas the proof of the pudding is performing well within complexity.

    6. Here’s what I found when I asked ChatGPT to diagnose my patients

      A comparison of ChatGPT responses to actual ER case descriptions. Interesting experiment by the author, though there shouldn't be an expectation for better results than it gave.

  7. Dec 2022
    1. Solving the gargantuan challenge posed by complex chronic diseases demands seismic shifts in research funding, medical training, and public attitudes.

      Not to mention the myopic insurance- and profit-driven "healthcare" industry itself.

  8. Oct 2022
    1. A study across the population of Scotland researched the affects of covid by comparing those with a positive PCR test with a control group that did not have covid. Vaccinations were shown to decrease symptoms. There are concerns about long-term effects as the virus becomes endemic.

  9. Sep 2022
  10. www.justine-haupt.com www.justine-haupt.com
    1. Healthcare should be a human right.

      Healthcare is a service provided by others.

      When a person asserts that they have a right to the labor of others, this stakes a claim of ownership over that person and their labor.

      "slavery, condition in which one human being was owned by another." https://www.britannica.com/topic/slavery-sociology

      Everyone has a right to health, but they can make no such claim to the service of others to maintain it.

  11. Aug 2022
  12. Jul 2022
    1. We don’t expect National Defence or health care to promote growth: we just accept that territorial integrity and a healthy populace are good things.

      Been making that point about health (especially since, like education, it's a provincial jurisdiction). It's easy to think of perverse incentives if a profit motive dominates education and health. Physicians would want people to remain sick and teachers would prefer it if learners required more assistance.

      Hadn't thought enough about the DND part. Sure gives me pause, given the amounts involved. Or the fact that there's a whole lot of profit made in that domain.

      So, businesspeople are quick to talk about "cost centres". Some of them realize that those matter a whole lot.

    1. Medical AI’s social impact is not merely a question of practice but also the insufficiency of its promise
  13. Apr 2022
    1. Eric Topol. (2021, April 23). Just published @TheLancet: Effect of vaccine in >23,000 health care workers https://t.co/ohy3VyHM3C Dose response: No vaccine 977 infections; 1 dose 71 infections; 2 doses 9 infections (14|8|4 per 10,000 person-days) "can prevent both symptomatic and asymptomatic infection " https://t.co/EybVBFmXrU [Tweet]. @EricTopol. https://twitter.com/EricTopol/status/1385729322472730626

  14. Mar 2022
  15. Feb 2022
    1. Nursing professionals are facing with severe sleep problems during the covid 19 pandemic time. Nurses were asked to work in an environment that had a more increased level of risk than ever before. Depression and anxiety from the workplace could affect the confidence of healthcare workers in themselves as well as general trust in the healthcare system. This will lead to their turnover intention which may undermine the efforts of the governments to control the COVID-19 pandemic. The rising concern may change the working schedules of healthcare workers, offering more occupational healthcare support.

  16. Jan 2022
    1. Barry McAree 💙. (2022, January 6). Teachers on these islands will get FFP2(rightly so).Healthcare workers on other parts of these islands..nah!..Surgical masks/spit guards/not PPE,for working with COVID-positive patients risking other patient’s, our own & our family’s health.”Protect the NHS”🤔⁦@CMO_England⁩ https://t.co/OngrD5BBPU [Tweet]. @BarryMcAree. https://twitter.com/BarryMcAree/status/1478883258305814536

  17. Dec 2021
    1. shinydoc. (2021, December 12). I love how I, an actual GP...who was involved in the initial covid vaccination programme ...has to tune in at 8pm with the public to find out that apparently we are vaccinating the entire adult population with boosters by the end of the year [Tweet]. @irishayesha. https://twitter.com/irishayesha/status/1470123478221303810

  18. Nov 2021
    1. Benjamin Veness. (2021, November 2). Singapore’s 🇸🇬 Senior Minister of State for Health, Dr Janil Puthucheary, told Parliament on 1 November: “I hope my explanation has helped members understand why although we say we are living with COVID-19, we cannot just open up, and risk having the number of cases shoot up.” [Tweet]. @venessb. https://twitter.com/venessb/status/1455396047765733376

    1. ReconfigBehSci. (2021, November 2). interestingly the Singapore Health Minister also mentions “boosting through mild infections”—A concept that is currently generating much furore in the UK in the wake of the release of the JCVI minutes on child vaxx decisions 1/n [Tweet]. @SciBeh. https://twitter.com/SciBeh/status/1455445587910922240

  19. Oct 2021
    1. Kenneth Baillie. (2021, October 27). When a healthcare system fails, increasing numbers of people suffer and die needlessly. That’s all. If you aren’t a patient or staff, you don’t see it. But this is happening, now, all over the UK. 2/n [Tweet]. @kennethbaillie. https://twitter.com/kennethbaillie/status/1453422360795680769

  20. Sep 2021
    1. The process of pharmacy application development is not much different from any other. Nevertheless, it is crucial to find a company that can take into account all the needs of your business and implements them in a customized solution. Using a ready-made template, you simply dissolve among competitors, and a completely individual solution will allow you to implement all your plans. Remember to have good contractors implementing this solution.

      Currently, delivery options for basic needs such as food, groceries, clothing are available to any business, and the pharmaceutical industry is no exception. It means customers expect their medicines will be delivered in time without any interruptions.

  21. Aug 2021
    1. Pham, Q. T., Le, X. T. T., Phan, T. C., Nguyen, Q. N., Ta, N. K. T., Nguyen, A. N., Nguyen, T. T., Nguyen, Q. T., Le, H. T., Luong, A. M., Koh, D., Hoang, M. T., Pham, H. Q., Vu, L. G., Nguyen, T. H., Tran, B. X., Latkin, C. A., Ho, C. S. H., & Ho, R. C. M. (2021). Impacts of COVID-19 on the Life and Work of Healthcare Workers During the Nationwide Partial Lockdown in Vietnam. Frontiers in Psychology, 12, 563193. https://doi.org/10.3389/fpsyg.2021.563193

    1. Unfortunately, some patients receive "surprise doctor bills" when treated at an in-network facility (e.g., hospital) but not all the physicians who practice at that facility participate in their health plan's network. If you need to go to the hospital for a procedure that's not an emergency, ask whether every provider is in your health plan's network.

      A hospital might accept a specific insurance plan, but the doctor treating you might not. This means that patients have to do their due diligence in finding out if their physicians are in their net-work. This will avoid 'surprise doctor bills'.

    2. Talk to your nurses. Studies routinely identify nursing as the profession most trusted by the public. People feel comfortable talking to nurses. Do not hesitate to ask nurses questions about your health or treatment plan. Nurses are patient advocates. They are adept at interpreting people's questions and responding using easily understood terms. Every day, nurses help patients, families and the community navigate the complex health system

      Talk to your nurses!

      • Nurses are the most trusted in healthcare
      • Great at advocating for patients
      • Excellent in breaking down jargon into layman terms
      • Essential to healthcare
    3. Provide more opportunities for new talent. Because healthcare has been relatively solid and stagnant in what it does, we're losing out on some of the new talent that comes out — who are developing artificial intelligence, who are working at high-tech firms — and those firms can pay significantly higher than hospitals for those talents. We have to find a way to provide some opportunities for that and apply those technologies to make improvements in healthcare.

      Intestesing. Mr. Roach thinks healthcare is not doing enough to attract new types of talent (AI and emerging tech) into healthcare. We seem to be losing this talent to the technology sector.

      I would agree with this point. Why work for healthcare with all of its massive demands and HIPPA and lack of people knowing what you are even building. Instead, you can go into tech, have a better quality of life, get paid so much more, and have the possibility of exiting due to a buyout from the healthcare industry.

    4. To advance healthcare reform and new/innovative population health initiatives, hospital leaders need to focus on aligning our interests with our patients. For too long, our fee-for-service reimbursement system has provided incentives for providers to develop services that generate revenue based on more utilization (caring for people who are sick), when our patients obviously would prefer less utilization (to be healthy). There will always be a role for hospitals to care for the sick and injured, but if we are going to truly bend the cost curve and be successful in the world of population health, we must find new ways to align our incentives with our patients' incentives, so that "improving the health of our community" is not only a clinical goal for providers, but a financial goal as well.

      Dr. Kniffin says that the incentivies for healthcare do not align with those of the patients. The current payment structure incentivizes hospitals to have more tests and use more resources (caring for those that are sick). While patients would like less resources to be used and get back to being healthy. This is at odds with each other. So it would be best if we (healthcare) could realign with the patient's incentive of being healthy and use less resources.

    5. Keep in mind potential for waste or unnecessary spending. I think patients are starting to pay closer attention to the necessity of care rendered now because as more patients have high-deductible insurance plans, how they spend their money becomes critically relevant to them.

      A high-deductiable plan is an insurance which has a lower monthly payment at the cost of higher fees before the insurance covers the cost (deductible).

      Dr. Bauer from Hackensack Meridian Health sees more patients having higher-deductible insurance plans. This results in patients scrutinizing costs and tests because they have to pay for those directly.

    1. Zeke Emanuel on Twitter: “Masks are off, theaters and indoor dining are back: Life seems to be returning to normal. But the highly transmissible Delta variant is spreading quickly, & we aren’t even halfway to a fully vaccinated population. It’s time for employer vaccine mandates. Https://t.co/34UArFfHN5” / Twitter. (n.d.). Retrieved August 1, 2021, from https://twitter.com/ZekeEmanuel/status/1418266496749428737?s=20

  22. Jul 2021
    1. If we had truly robust standards for electronic data interchange and less anxiety about privacy, these kinds of data could be moved around more freely in a structured format. Of course, there are regional exchanges where they do. The data could also be created in structured format to begin with.

      This does exist. Fast Healthcare Interoperability Resources (FHIR; pronounced 'fire') is an open standard that describes data formats and elements (the 'resources' in the name), as well as an application programming interface (API) for exchanging electronic health records.

      See more here: https://hl7.org/fhir/

    1. Gargano, J. W., Wallace, M., Hadler, S. C., Langley, G., Su, J. R., Oster, M. E., Broder, K. R., Gee, J., Weintraub, E., Shimabukuro, T., Scobie, H. M., Moulia, D., Markowitz, L. E., Wharton, M., McNally, V. V., Romero, J. R., Talbot, H. K., Lee, G. M., Daley, M. F., & Oliver, S. E. (2021). Use of mRNA COVID-19 Vaccine After Reports of Myocarditis Among Vaccine Recipients: Update from the Advisory Committee on Immunization Practices — United States, June 2021. MMWR. Morbidity and Mortality Weekly Report, 70(27), 977–982. https://doi.org/10.15585/mmwr.mm7027e2

    1. Sarah Kliff on Twitter: “Coronavirus vaccines are free—But 9 percent of Americans say they’re not getting one because they are worried about cost. I see this a lot in my reporting: Patients who don’t seek care because they’re become so accustomed to surprise bills that follow. Https://t.co/gu6oDnlvhB” / Twitter. (n.d.). Retrieved July 2, 2021, from https://twitter.com/sarahkliff/status/1395032095819542528?s=20

  23. Jun 2021
    1. Thompson, M. G., Burgess, J. L., Naleway, A. L., Tyner, H. L., Yoon, S. K., Meece, J., Olsho, L. E. W., Caban-Martinez, A. J., Fowlkes, A., Lutrick, K., Kuntz, J. L., Dunnigan, K., Odean, M. J., Hegmann, K. T., Stefanski, E., Edwards, L. J., Schaefer-Solle, N., Grant, L., Ellingson, K., … Gaglani, M. (2021). Interim Estimates of Vaccine Effectiveness of BNT162b2 and mRNA-1273 COVID-19 Vaccines in Preventing SARS-CoV-2 Infection Among Health Care Personnel, First Responders, and Other Essential and Frontline Workers—Eight U.S. Locations, December 2020–March 2021. MMWR. Morbidity and Mortality Weekly Report, 70(13), 495–500. https://doi.org/10.15585/mmwr.mm7013e3

    1. V Shah, A. S., Gribben, C., Bishop, J., Hanlon, P., Caldwell, D., Wood, R., Reid, M., McMenamin, J., Goldberg, D., Stockton, D., Hutchinson, S., Robertson, C., McKeigue, P. M., Colhoun, H. M., & McAllister, D. A. (2021). Effect of vaccination on transmission of COVID-19: An observational study in healthcare workers and their households [Preprint]. Public and Global Health. https://doi.org/10.1101/2021.03.11.21253275

    1. Woolf, K., McManus, I. C., Martin, C. A., Nellums, L. B., Guyatt, A. L., Melbourne, C., Bryant, L., Gogoi, M., Wobi, F., Al-Oraibi, A., Hassan, O., Gupta, A., John, C., Tobin, M. D., Carr, S., Simpson, S., Gregary, B., Aujayeb, A., Zingwe, S., … Pareek, M. (2021). Ethnic differences in SARS-CoV-2 vaccine hesitancy in United Kingdom healthcare workers: Results from the UK-REACH prospective nationwide cohort study [Preprint]. Public and Global Health. https://doi.org/10.1101/2021.04.26.21255788

    1. Hall, V. J., Foulkes, S., Saei, A., Andrews, N., Oguti, B., Charlett, A., Wellington, E., Stowe, J., Gillson, N., Atti, A., Islam, J., Karagiannis, I., Munro, K., Khawam, J., Group, T. S. S., Chand, M. A., Brown, C., Ramsay, M. E., Bernal, J. L., & Hopkins, S. (2021). Effectiveness of BNT162b2 mRNA Vaccine Against Infection and COVID-19 Vaccine Coverage in Healthcare Workers in England, Multicentre Prospective Cohort Study (the SIREN Study) (SSRN Scholarly Paper ID 3790399). Social Science Research Network. https://doi.org/10.2139/ssrn.3790399

    1. We didn't have papers. On top of that, we're not from there. So we don't have papers. Not papers, but you know how you have to get the medical shots. We had to redo all of that stuff. So my mom got the shots, did all the immunization records and all that stuff.

      Time in US - immigration status - being secretive - in the shadows - healthcare

    2. When I was really young, I had gotten accident that required surgery and I needed to get that surgery done, so when I went to the hospital and get it done there was actually a couple of people from a criminal organization that were supposed to, I guess, kill somebody in there. I remember this like it was yesterday. I had a little breathing mask on and the doctor was telling me to breathe when he counted the eight, I could just hear the gunshots.

      before the US - family, healthcare

    1. Within three to six months. It didn't take that long … immediately kind of. I think one of my uncles took it upon himself to take care of us, and since my mom … my mom at the time, we did not know she had a tumor in the back of her brain. Right where her brain stem is, she had a huge tumor there and we had no idea. Nobody knew. She doesn't remember a lot of this. I don't know if it's because of the emotional trauma or because of the tumor, but once we got to Chicago, it was evident that something was wrong with my mother and she started going to the doctor.

      Homelife - family taking care of each other Mother and need for medical intervention

  24. May 2021
    1. Schmitt, H.-J., Booy, R., Aston, R., Van Damme, P., Schumacher, R. F., Campins, M., Rodrigo, C., Heikkinen, T., Weil-Olivier, C., Finn, A., Olcén, P., Fedson, D., & Peltola, H. (2007). How to optimise the coverage rate of infant and adult immunisations in Europe. BMC Medicine, 5, 11. https://doi.org/10.1186/1741-7015-5-11

    1. Hall, V. J., Foulkes, S., Saei, A., Andrews, N., Oguti, B., Charlett, A., Wellington, E., Stowe, J., Gillson, N., Atti, A., Islam, J., Karagiannis, I., Munro, K., Khawam, J., Chand, M. A., Brown, C. S., Ramsay, M., Lopez-Bernal, J., Hopkins, S., … Heeney, J. L. (2021). COVID-19 vaccine coverage in health-care workers in England and effectiveness of BNT162b2 mRNA vaccine against infection (SIREN): A prospective, multicentre, cohort study. The Lancet, 0(0). https://doi.org/10.1016/S0140-6736(21)00790-X

  25. Apr 2021
    1. Dr Kamna Kakkar. (2021, April 20). If things come down to this, doctors are going to be at the recieving end of all patient wrath. As much as I pray for Delhi patients’ lives, I pray for the safety of my colleagues. #DelhiLockdown https://t.co/Q7RaIj68RB [Tweet]. @drkamnakakkar. https://twitter.com/drkamnakakkar/status/1384535301243109380

    1. Nissim Mannathukkaren നിസ്സിം മണ്ണത്തൂക്കാരൻ. (2021, April 8). ‘The hand of God’—Nurses trying to comfort isolated patients in a Brazilian Covid isolation ward. Two disposable gloves tied, full of hot water, simulating impossible human contact. Salute to the front liners and a stark reminder of the grim situation our world is in!@sadiquiz https://t.co/eldzkT4JHa [Tweet]. @nmannathukkaren. https://twitter.com/nmannathukkaren/status/1380129214259720202

  26. Mar 2021
    1. Walker, P. G. T., Whittaker, C., Watson, O. J., Baguelin, M., Winskill, P., Hamlet, A., Djafaara, B. A., Cucunubá, Z., Mesa, D. O., Green, W., Thompson, H., Nayagam, S., Ainslie, K. E. C., Bhatia, S., Bhatt, S., Boonyasiri, A., Boyd, O., Brazeau, N. F., Cattarino, L., … Ghani, A. C. (2020). The impact of COVID-19 and strategies for mitigation and suppression in low- and middle-income countries. Science, 369(6502), 413–422. https://doi.org/10.1126/science.abc0035

    1. Iversen, K., Bundgaard, H., Hasselbalch, R. B., Kristensen, J. H., Nielsen, P. B., Pries-Heje, M., Knudsen, A. D., Christensen, C. E., Fogh, K., Norsk, J. B., Andersen, O., Fischer, T. K., Jensen, C. A. J., Larsen, M., Torp-Pedersen, C., Rungby, J., Ditlev, S. B., Hageman, I., Møgelvang, R., … Ullum, H. (2020). Risk of COVID-19 in health-care workers in Denmark: An observational cohort study. The Lancet Infectious Diseases, 0(0). https://doi.org/10.1016/S1473-3099(20)30589-2

  27. Feb 2021
    1. Tang, J. W., Bahnfleth, W. P., Bluyssen, P. M., Buonanno, G., Jimenez, J. L., Kurnitski, J., Li, Y., Miller, S., Sekhar, C., Morawska, L., Marr, L. C., Melikov, A. K., Nazaroff, W. W., Nielsen, P. V., Tellier, R., Wargocki, P., & Dancer, S. J. (2021). Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus (SARS-CoV-2). Journal of Hospital Infection, 0(0). https://doi.org/10.1016/j.jhin.2020.12.022