...And that totally excites me, and if you are a geek-doctor like me, I am sure you would share in the excitement. As a resident I keep encountering countless frustrations with current EMRs and moments of "Wish Steve Jobs made EMRs too", I know for a fact that medical information access, presentation and computing is no longer just geeky business, it can have real tangible, implications in efficacy, patient safety, cost savings and the dollar bottomline. And enabling physicians to take leadership roles in driving the clinical information flow in a health system will need special training, that deserves a separate fellowship.
So, In March 2007, the Robert Wood Johnson Foundation awarded a grant to the American Medical Informatics Association to brainstorm over making two documents that the American Board of Medical Specialties (ABMS) would need to create the medical subspecialty of clinical informatics - These are ready, and you can read them here
A few places already have fellowships for MDs in Medical informatics, but recognizing that as a sub-specialty will be awesome :). Soon it will be standard practice for hospitals to have a clinical informatics specialist who practices clinical medicine and and also provides leadership to the clinical IT systems. I had already touched on Chief Medical Information Officer salaries before, other possible positions after such a fellowship could be lucrative systems design & management positions with medical software vendors, academic research positions in universities or even hospitalist + IT combined positions.
Good Books:
- Introduction to Clinical Informatics (Health Informatics)
- Information Technology for the Practicing Physician (Health Informatics)
Diabetic patient followups make up a huge majority of primary care stuff that both residents and medical students gotta handle, here's a ABCD style mnemonic to remember what to keep tabs on for diabetics:
A - A1c : Target A1cHb Less than 6.5
B - Blood Pressure target Less than 130 /80 in Diabetics to slow renal failure! Start off with ACE inhibitors , and remember annual microalbuminuria checks
C - Cholesterol Check: LDL less than 100 is target, less than 70 recommended
D - D Vitamin ! Low Vit D levels in DM increases atherosclerosis risks
E - Eye exam, annual, by an opthalmologist or optometrist
F - Foot exam with every visit
G - Gonadial Hormone --> Testosterone levels in Males - Why ? 1/3rd of Diabetic men have low testosterone levels which worsens insulin resistance & obesity - Read this
H - Holistic Health advice including Lifestyle, exercise, smoking cessation, Diet education and weight goals
Emailed to me by a reader who recently started his residency - and here's a real cool "prescription pill" bottle that their residency program gave all incoming interns:
Here's the medicine label ;):
And here are the contents !!
And here are intructions...
Sweeeet...
Just started my second year of residency and my first rotation is a relaxed primary care clinic rotation..lovin it ! The last week, Mr. Z, a jolly white man showed up for his 6-month followup with his very pleasant wife. I went over his notes, problem list, labs and meds on the Electronic Medical Record, which all looked fine and optimal. On the vitals screen, I saw that his blood pressure reading today was @ 156/94, and a similar one in the previous 2 visits, but he wasn't on any medications. I brought this up and he said, "Oh yea, doctors told me it was a doctor coat hypertension or something, because my pressures run perfectly fine at home, in the 120s and 80s"
New @USMLEtoMD
