Large-scale electronic patient record (EPR) programmes promise much but sometimes deliver little, according to a new study by UCL researchers that reviewed findings from hundreds of previous studies from all over the world. The major literature review, published in the US journal Milbank Quarterly, identifies fundamental and often overlooked tensions in the design and implementation of EPR programmes. The findings have implications for President Obama's election promise of "a computerized medical record for every American within five years", and for other large-scale EPR programmes around the world. First author Professor Trish Greenhalgh of UCL's Department of Open Learning said: "EPRs are often depicted as the cornerstone of a modern health service.
Radiation doses from common CT procedures vary widely and are higher than generally thought, raising concerns about increased risk for cancer, according to a new study led by UCSF imaging specialists. "In day-to-day clinical practice, we found significant variation in the radiation doses for the same type of computed tomography procedures within institutions and across institutions, " said lead investigator Rebecca Smith-Bindman, MD, a professor of radiology at UCSF. "Our results highlight the need for greater standardization because this is a medical safety issue." Computed tomography imaging, known as CT, is a diagnostic procedure that uses special x-ray equipment to obtain cross-sectional pictures of the body that provide detailed images of organs, bones, and other tissues.
Although growing numbers of people check their symptoms with "Dr. Google" or seek other medical advice online, many still lack the access and skills to take advantage of the Web's wealth of health information. But a community-based coalition in Washington, D.C., is working to close that information gap through outreach and education programs, with some success, according to a report in the journal Health Promotion Practice. In hands-on workshops provided by the Health Information Partners coalition, researchers measured a 26 percent improvement in the workshop participants' ability to use the Internet, evaluate the content on health Web sites, and find credible health information online.
New patients using Veterans Affairs health services are more likely to be younger and women. The Associated Press reports on a Veterans Affairs Medical Center in Martinsville, W.Va., that is increasingly seeing women in their twenties who served in Iraq and Afghanistan. "The hospital sees nearly twice as many women it did before the Sept. 11 attacks. Administrators opened a women's clinic and are trying to take female veterans into consideration when deciding everything from the color of the walls to the size of the prosthetics offered." Problems remain in the VA health system for providing care to female veterans, including a lack of privacy for bathing and examinations that was noted by congressional investigators last summer.
The Senate is battling over a proposed amendment that would allow prescription drugs to be imported from other countries where prices are lower. "Drugmakers intensified their lobbying push Monday against a popular proposal to allow Americans to buy cheaper drugs from other countries, one of several heated disputes that have bogged down negotiations over a heath-care reform bill, " The Washington Post reports. The dispute complicated Senate Democrats' efforts to rally 60 pass health reform legislation before Christmas and also "poses a particularly difficult political challenge for President Obama, who co-sponsored a similar bill when he was in Congress and who included funding for the idea in his first budget.
Adults who used an electronic lock-out system to reduce their television time by half did not change their calorie intake but did expend more energy over a three-week period, according to a report in the December 14/28 issue of Archives of Internal Medicine, one of the JAMA/Archives journals. The average adult watches almost five hours of television per day, according to background information in the article. Some efforts to prevent and reduce obesity have focused on modifying diet and physical activity, but newer strategies have involved reducing sedentary behaviors such as TV watching. Not only may reducing TV time allow time for more active endeavors, it may also help alleviate chronic sleep deprivation, potentially linked to obesity.