Medical Device Innovation: Avoiding Failure by Managing Risk

Innovation in the medical device industry contributes significantly to our country's economy and to the quality of healthcare for our citizens.  One might say that innovation drives the medical technology world, building on science and entrepreneurship, and tends to be the domain of small companies.  However, the path to innovative success is fraught with difficulties and most small, entrepreneurial medical technology companies end up as business failures.  A better understanding of innovation and risk management may be helpful to increase the success of the small medical technology company.

Innovation is usually understood as a change in the process for doing something or the application of new inventions and discoveries.  There is a distinction here between the concept of invention and the notion of innovation.  Invention is the creation of a new product, process, or service from new or existing knowledge.  The innovation process describes how science and knowledge becomes product in the market place through two distinct movements.  In the first phase of the innovation process, basic research discovers or creates new knowledge which has an application or an invention.  In the second phase, innovation results from the commercialization of that invention; that is, taking the invention into the marketplace and generating income.  Inventors generally do not profit from their work, yet innovators produce, market, and profit from their innovations.

The challenges in the second phase of the cycle are formidable.  The invention-to-innovation process is more frequently driven by customer demand or market pull than the technology itself.  In addition, the applied new business concept can result from happenstance or luck as much as deliberate forbearance.  The process, invention to market innovation, is cyclic, moving in spirals rather than linear vectors, often over years, perhaps decades.  Finally, the key component to a successful innovation is a strong business plan used to commercialize the product.  Indeed, without a successful business model, there is not innovation, just invention.

The successful business plan must include a real reading of the market place, valuing the market potential and creating an appropriate marketing plan.  Finance, capitalization, and eventually customer demand are dependent on the communications and delivery of the message that a robust marketing process facilitates.  This basic concept-a sound marketing plan-is often the least developed in small medical technology companies, which tend to be driven by valuable scientists and technical staff, who may underestimate the need for the business model.  Out of three thousand ideas for new products, only one becomes a successful innovation in the market place.

A successful business plan begins with analysis of the company itself, the industry, the customers, and the competition.  Each of these areas is critical and interdependent.  The entrepreneur of a medical technology company must understand and articulate his or her company's strategy, organization, product, and service, including what unique qualifications the company has to service its target markets.  In addition, the analysis must also understand the playing field in which the company will be competing, responding to questions such as what are the target market segments, the sizes of these segments, and the trends in the industry subsector(s).  In the medical device industry, this analysis also includes the regulatory perspective: understanding how the FDA and other agencies will regard the invention and its success.  Does clinical data support the strategy and help to make the case for approval?

Building on the industry analysis, the customer analysis should demonstrate the unique needs of the target customers and then show how the company's products and services satisfy those needs such that the customer will want and indeed pay for them, once approved.  The company must also have a true understanding of the competitive landscape, identifying direct and indirect competitors and their strengths and weaknesses, in order to delineate the company's competitive advantages.  How will this medical technology be received in the ever-changing worlds of health care, reimbursement, and patient acceptance?

A successful business plan has viewpoints on marketing, operations, human resources, finance, and risk management.  The marketing plan should address the company's image and brand and its promotion and pricing strategy.  Operational design focuses on the functions to run the business, including manufacturing, delivery, sales, and quality assurance.  The human resources component addresses the "who" of the company; that is, it identifies the key personnel, management, board of directors, advisors, and leaders.  The financial plan outlines the revenue.  Profitability, costs, and capital, including when and how earnings will be realized.  For investors looking for opportunity, especially in the medical technology sector, having a sound financial plan is a key attraction.

Finally, risk management is an inherent component of a successful business plan.  Risk management is the analysis of possible loss and the determining, minimizing, and preventing of accidental economic or physical loss in a business.  Enterprise risk management is not about eliminating risk, but rather it is about making informed risk choices.  This process, analyzing and minimizing risk, helps propel inventions to market, supporting investment and freeing resources for innovation.  Risk comes in many areas and can be addressed through a combination of best practices as well as risk transfer through insurance.  For instance, products and clinical trial risk issues can be addressed through research design and liability insurance.  Capital investment, physical assets, and manufacturing risk are mitigated with appropriate property and transportation insurance.  The health and welfare of employees and their relationships with the employer are addressed in human resource policies and benefits, and with insurance products such as workers' compensation, disability, and employment practices.  Finally, stakeholder and shareholder risk is often protected with management liability coverage in directors and officers and fiduciary insurance.

Entrepreneurial inventors face daunting circumstances in seeking to become successful innovators.  Not only must their science and inventions be well established, they must also have solid business plans and a modicum of luck.  The business process with the innovation cycle is built upon appropriate analysis of the industry, customer, competition and market place with strategic plans to address leadership, marketing, finances, operations, and risk.  With a sound business plan, inventors can convert their ideas into cash moving their knowledge to innovation.  For more information on best practices for business planning and risk management, please visit The Hartford's Technology and Life Science website, www.thehartford.com/info/ technology or contact The Hartford at medtechlifesci@thehartford.com.

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Medical Device Failures: Case Studies from an Engineering Perspective

?The growth in healthcare technology in recent years has been exponential, and the more medical devices in use, the more frequent medical device failure becomes. A clinical engineer–one who studies the cause of device failures before and after they occur–can offer a unique perspective on healthcare technology's common failure modes and the prevention of such failures.

This webinar will:

Briefly outline recent industry growth and its impact on risk;Describe the role of the clinical engineer in identifying and preventing medical device failure; andProvide real-world examples of various healthcare technology failures and the lessons learned from them.Richard J. Daken, Jr., P.E. is Medical Technology Division Manager of Rimkus Consulting Group, Inc. Mr. Daken holds both a Bachelors and a Masters of Science in Electrical Engineering from the New Jersey Institute of Technology. He has more than 30 years' experience involving technical investigations and failure analyses involving medical equipment and accompanying procedural issues within a hospital or healthcare setting. Mr. Daken's medical equipment expertise includes MRI machines, CAT scan machines, gamma knives, surgical lasers, linear accelerators, heart-lung bypass machines, defibrillators, AEDs, and cardiac monitors, as well as many other medical devices.Mr. Daken is a court-qualified expert at both the state and federal levels, testifying on electrical distribution system failures, electrical shock and electrocution incidents, electrical equipment-related injuries, damage due to maintenance issues, damage to equipment due to electromagnetic interference, fire damage, water damage, and injuries related to improper procedure and/or noncompliance with appropriate standards, regulations, and product manuals.Mr. Daken has been an Adjunct Professor at New Jersey Institute of Technology since 1995. He has taught courses in biomedical technology engineering, clinical engineering and electrical engineering technology.
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Medical Device and Drug Theft: An Emerging Source of Property & Products Liability for the Medtech Industry

?Both FDA and industry groups have identified the theft of medtech products as an emerging threat to public health. Likewise, the theft of these products is an emerging source of liability for the companies that manufacture and distribute them. Learn more about theft and how it is impacting the medtech industry. 

Why your product is vulnerable to theft during transit and tips for minimizing cargo theft; andStrategies for maintaining control of foreign suppliers and thereby minimizing product liability risk.Joseph A. Coray is the Vice President and Leader of The Hartford's Technology & Life Science Practice and Marine Practice.  He is responsible for all execution activities of the two groups, including overseeing field sales, underwriting and strategy for The Hartford's insurance work for biotechnology, medical technology, and pharmaceutical industries.Joe joined The Hartford in 2005 and has been in the insurance industry since 1987. He has a bachelor's degree from Saint Francis University, and master's degree from St. Bernard's Institute. He has earned Associate in Insurance Management designation from the Insurance Institute, and is certified Six Sigma Green Belt. Sara E Dyson, Esq. is the Assistant Vice President of Loss Control for the Medmarc Insurance Group. Her primary responsibility is to develop products and services to assist companies control products liability risks, losses, and associated costs.In 2012, Sara was invited to join the Health Sciences Council for Underwriter's Laboratory (UL). She will advise UL on safety trends for medical devices.Sara received her law degree from the University of Wisconsin Law School and is a member of the Wisconsin and Virginia Bar Associations. She is also a graduate of the University of Michigan, where she received a bachelor's degree.
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Complaint Handling for Medical Device Manufacturers

Medical device manufacturers must ensure that they have a well-designed system to address complaints related to their products.  Components of a well-designed system include: process/procedure, trained personnel, and proper record keeping.

A complaint is any written, electronic, or oral communication that alleges deficiencies related to the identity, quality, durability, reliability, safety, effectiveness, or performance of a device after it is released for distribution.  The broad language concerning what constitutes an alleged “deficiency” means that manufacturers should be extremely cautious when determining what is and is not a complaint.  It may be a good rule to treat any indication of dissatisfaction with a product as a complaint.

Manufacturers must be prepared to address not only complaints made directly to them, but also those they learn about from any source, including but not limited to reports and publications prepared by others.

The Food and Drug Administration (FDA) requires the manufacturer of a medical device to formally designate a unit within the company to oversee complaint handling.  The personnel responsible for handling complaints should have the necessary background, education, training, and experience to handle their roles, including a thorough understanding of FDA complaint handling regulations.  Training should be on-going and well-documented.

Written procedures for complaint handling will ensure that all complaints are reviewed in a timely and uniform manner.  A complaint log or complaint file is required and should be updated whenever necessary. Basic information for the file includes but is not limited to the name of the device, date the complaint was received, complainant name and address, nature and details of the complaint, and the device identification/control number.

When reviewing a complaint, be sure to determine whether any additional investigation is necessary.  Any complaint involving the possible failure of a device, labeling, or packaging to meet any of its specifications should be investigated further.  Pay special attention to whether the complaint triggers any reporting requirements under FDA regulations.  If the complaint triggers a Medical Device Report (MDR), ensure that the complaint file is clearly identified or maintained separately from other complaint files.  (For additional information, please see the “Risk Management 101” on Medical Device Reporting.)

If an investigation is required, the basic information in the complaint file described above should be supplemented by including the dates and results of the investigation, any corrective action taken, and any communications to the complainant.  Should the investigation trigger a need to make an MDR to the FDA, include information as to whether the device failed to meets its specifications, whether it was being used for treatment or diagnosis, and the relationship, if any, of the device to the reported incident or event.

When no investigation is made, maintain a record that describes the reason that no investigation was made and the name of the individual responsible for the decision not to investigate.

Complaint and investigation files must be maintained for a period equal to the expected life of the device, but in no case less than two years from the date the manufacturer releases the device for commercial distribution.

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Medical group said key elements well woman exams

Tuesday, 24 July, HealthDay News)--the latest guidelines for cervical cancer screening say that most women don't need annual Pap smears, but they still need yearly exams well woman with their obstetrician/gynecologist, according to the American College of Obstetricians and Gynecologists (ACOG).

In the opinion of the Committee, released Monday, the College outlines when women should undergo pelvic exams, which women need clinical examination of mammary glands and why the Bureau visit the annual well woman is important.

Annual well woman exam is an opportunity for doctors to advise patients about following a healthy lifestyle and reducing health risks. The trip includes a physical exam that assesses general health, including blood pressure and weight.

A pelvic exam is a common part of the visit, the OB-GYN and includes three parts: external examination, an internal exam and exam mirror internal/external keyboard, according to the press release of the APS. Women should begin annual pelvic exams are held at the age of 21.

Young women do not have to pass an internal examination, if they do not have signs of menstrual disorders, vaginal discharge, pelvic pain or other symptoms related to reproductive, said College.

Screening for sexually transmitted infections can be done using urine or vaginal tampons without an internal exam.

Another important part of the visit, the good woman is a clinical breast exam. This should be done every one to three years for women aged 20 to 39, according to ACOG and other groups, health/medical. Women aged 40 years and older must have annual mammograms and clinical breast exams annually, ACOG recommends.

Decisions on the appropriateness of the internal pelvic exam breast exams or should always be with the consent of the patient, "said ACOG.

In the August issue of the journal obstetrics and Gynecology & appears in the Committee's opinion.

--Robert Preidt Copyright © 2012 HealthDay. All rights reserved. Source: American College of Obstetricians and Gynecologists, press release, July 23, 2012

View the original article here

"Steered" common marijuana among Teens and medical devices: study

THURSDAY, Aug. 2--HealthDay News) for the treatment of substance abuse among young people, many were used for medical marijuana, which was recommended for someone else, also known as "directed" medical marijuana, found that the new study.

The authors of the study, from the University of Colorado Anschutz Medical Campus in Aurora, Colorado, Idaho, suggest that the policy changes are needed to deter the misuse of medical marijuana by young people.

During the test, the lead Author Stacy Salomonsen-Sautel and colleagues questioned 164 young people aged 14-18 in two adolescent substance abuse treatment programs in Denver about their use of medical marijuana. Researchers found that nearly 74 teens use marijuana, which was recommended for someone else on average 50 times.

Compared with teens who do not use medical marijuana, those who began using drugs regularly in younger age and were also more dependent on marijuana and showed more signs of the disorder, according to the report published in the July issue of the Journal of the American Academy of | Child and Adolescent Psychiatry.

The researchers, however, stressed that the majority of teens believed that drug comes with little or no risk.

Because of recent changes to the rules of the State and Federal have door open to more legalized marijuana medical use in Colorado, the researchers suggested that teens using medical marijuana most likely got it from the registry identification card of an adult important for drugs.

The authors of the study concluded that the improved security measures are necessary to prevent medical marijuana in the hands of people that he should not, particularly teenagers.

"The high risk of many patients in the treatment of adolescent substance abuse medical marijuana transalpine were used on a number of occasions, which means that considerable changes direction takes place from registered users," Salomonsen-Sautel said in the journal messages. "Our results support the need for changes in the rules, which protect against medical marijuana to teenagers cross trade."

--Mary Elizabeth Dallas Copyright © 2012 HealthDay. All rights reserved. Source: Journal of the American Academy of Child and Adolescent Psychiatry, news release, 31 July 2012

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blogs-weekly review and blog carnival

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Scanning the news about concerns over explosion in medical imaging scans

In case you missed them, many stories reported on a new analysis of the explosion in the use of CT, MRI and other advanced imaging methods.

The Los Angeles Times: “Use of imaging tests soars, raising questions on radiation risk.”

Researchers looked at “data from patients enrolled in six large health maintenance organizations,” and “found that doctors ordered CT scans at a rate of 149 tests per 1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996.” Meanwhile, “MRI use nearly quadrupled during the period, jumping from 17 to 65 tests per 1,000 patients.”

The New York Times: “Radiation Concerns Rise With Patients’ Exposure.”

 ”The study, published in the Journal of the American Medical Association, says that while advanced medical imaging has undoubted benefits, allowing problems to be diagnosed earlier and more accurately, its value needs to be weighed against potential harms, which include a small cancer risk from the radiation.”

WebMD: “CT Scan Rates Tripled at HMOs in the Last 15 Years, Doubling Radiation Exposure to Patients”

Reuters:

The average radiation dose from a chest CT scan is 7 millisieverts, compared with 0.1 millisieverts for a typical chest X-ray, according to the American College of Radiology. But those levels can vary widely by machine, with some low-dose scanners delivering as little as 1.5 millisieverts for a chest CT, and some older machines delivering far higher doses.

Researchers say a radiation dose of 50 millisieverts starts to raise concerns about human health, and a dose of 100 millisieverts is thought to raise the risk of cancer.

MedPage Today: “Expanding indications, patient and physician demand, medical uncertainty, and defensive medicine likely all contributed to those trends.”

View the original article here

Scanning the news about concerns over explosion in medical imaging scans

In case you missed them, many stories reported on a new analysis of the explosion in the use of CT, MRI and other advanced imaging methods.

The Los Angeles Times: “Use of imaging tests soars, raising questions on radiation risk.”

Researchers looked at “data from patients enrolled in six large health maintenance organizations,” and “found that doctors ordered CT scans at a rate of 149 tests per 1,000 patients in 2010, nearly triple the rate of 52 scans per 1,000 patients in 1996.” Meanwhile, “MRI use nearly quadrupled during the period, jumping from 17 to 65 tests per 1,000 patients.”

The New York Times: “Radiation Concerns Rise With Patients’ Exposure.”

 ”The study, published in the Journal of the American Medical Association, says that while advanced medical imaging has undoubted benefits, allowing problems to be diagnosed earlier and more accurately, its value needs to be weighed against potential harms, which include a small cancer risk from the radiation.”

WebMD: “CT Scan Rates Tripled at HMOs in the Last 15 Years, Doubling Radiation Exposure to Patients”

Reuters:

The average radiation dose from a chest CT scan is 7 millisieverts, compared with 0.1 millisieverts for a typical chest X-ray, according to the American College of Radiology. But those levels can vary widely by machine, with some low-dose scanners delivering as little as 1.5 millisieverts for a chest CT, and some older machines delivering far higher doses.

Researchers say a radiation dose of 50 millisieverts starts to raise concerns about human health, and a dose of 100 millisieverts is thought to raise the risk of cancer.

MedPage Today: “Expanding indications, patient and physician demand, medical uncertainty, and defensive medicine likely all contributed to those trends.”

View the original article here

Medical Arms Race tale

Kudos to Gregory Warner of Marketplace and colleagues for creating this video.  I thought I’d posted this months ago, but apparently forgot.  Never too late.

View the original article here

Medical Arms Race tale

Kudos to Gregory Warner of Marketplace and colleagues for creating this video.  I thought I’d posted this months ago, but apparently forgot.  Never too late.

View the original article here

Best of Medical Blog - recensione settimanale e blog carnevale

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Best of Medical Blog - recensione settimanale e blog carnevale

The "Best of Medical Blogs-weekly review and blog carnival" is a weekly summary of the best medical Blog post. Feel free to send your suggestions to my email at clinicalcases@gmail.com. Best medical blog (BMB) is published every Tuesday, just like the old Grand Rounds.

Cultivate followers on social media, if you want to communicate science

From the blog science Soapbox http://goo.gl/cPQq1 and medical Museion http://goo.gl/QmEU7:

Social media platforms can be very limiting. For example, you can define genotype and Phenotype in 140 characters or less? If you want to use social media to communicate effectively, necessary for readers to drive somewhere.

Write a blog gives substance to your social media presence. You have the opportunity to talk about science in a meaningful way, which ultimately helps people better understand the world around them. Answering these questions is probably because you have first in science. Don't be afraid to share what you've discovered.

Are the doctors are afraid to be wrong?

From blogging to surgeon skeptical Scalpel: «I once did some work as an expert on a malpractice insurance company. Rarely there is a case that doesn't have many opportunities for second-guessing. When you know the outcome, you can always find something in the medical record that could have been done differently.

The current security climate and medicolegal patient creates a feeling among doctors that any mistake is to be extensively examined. This results in a similar situation to an athlete trying not to lose a game instead of trying to win. For those of you unfamiliar with the sport, that the strategy usually fails. Fear of being wrong can lead to excessive test too. " http://goo.gl/FWTbC

When did stop teaching the basics for residents and medical students?

Dr.% of the blog Rants Medical db loves ACGME competency 6 just fine, but also suggests a simple list of http://goo.gl/2sqip:

1. Take a complete history, relevant, accurate
2. make a proper physical examination
3. order the appropriate laboratory tests and interpret them completely and accurately
4. order the correct images and interventions and interpret them

Happy 5th Blogiversary!

Former plastic surgeon and blogger extraordinaire Dr. Bates of Ramona reflects on his 5 years of blogging and the medical community blogging. http://goo.gl/0EVJW

As blogging has helped me academically. According to Dr. cent: why I write almost everyday, my writing has improved dramatically http://goo.gl/GLNsL

Medicine-Stanford University Grand Rounds and social media

Graham Walker was one of the first medical blogger. Went on a break during his residency in emergency medicine (EM) and now has found new reasons to blog like a EM attending at Stanford University medical center. This is his talk on social media and medicine at Stanford University Grand Rounds: http://youtu.be/qtkggenLmlE

Dr. Walker: "my speech on the dissemination of medical information over time, as the internet and social networking are changing medication, how to use digital tools to be a better doctor at the bedside."

Here is the list of Graham of digital tools to improve the specialty.

Paper-based charts: how soon we forget http://goo.gl/Vspmp -Dr. Wes: suddenly, don't miss the paper charts anymore.

Dr. Wes: is how bad the cardiovascular risk of azithromycin? http://goo.gl/yVgfo -"Big data" related to "big mistake"?

Comments from Twitter:

Seth Trueger @ MDaware: some great stuff in there

Skeptical scalpel @ Skepticscalpel: thanks for including me.

View the original article here

Examples of medical marketing for the week: full body skin cancer scans, robotic hysterectomy

Both of these were sent to me by journalists:

An email pitch letter from a medical group:

Medical Office has First Full Body Scanner to Protect Against Skin Cancer

Dear xxxxx,

We thought that this might make for a very interesting and informative article. With the approach of summer break, this is a time when most people head outdoors. It’s important for people to remember to protect their families against one of the most common forms of cancer today: skin cancer. Current statistics show that 1 in 5 Americans will develop skin cancer in their lifetime.

—- uses the latest technology to detect and protect against skin cancer. They are the only practice in central (could be any state) to offer this system which creates a digital map of the entire body.

Now let’s look at the evidence:  The US Preventive Services Task Force states that “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

The other example came from a journalist who wrote, “Doesn’t it seem particularly exploitative to use a 26-year-old woman’s hysterectomy for this?” The news release/pitch:

Surgeons at xxx Health Center have completed the first robot-assisted surgery in xxxx County.

The first patient was 26-year-old xxx, who underwent a robot-assisted hysterectomy April 13.

Hysterectomies and other gynecological procedures are the first of many robot-assisted surgical procedures that will be offered at xxx.

“We are proud to offer the most high-tech, minimally invasive treatment options available anywhere right here at xxx. Now our patients can benefit from the latest surgical technologies without leaving home,” says (the) president of xxx Health Center.

For advertising disguised as news, see this puff piece in the business section of The Tennessean online, “daVinci robot works miracles.” 

Addendum 5 hours later:  The Nashville Scene website reports, “Tennessean Farms Out Health Section to Hospital Flacks.“  And Paul Raeburn of the Knight Science Journalism Tracker writes:

“The changes come as the Tennessean institutes a paywall for many of its stories. (Newspaper management) said that because of the paywall, “The Tennessean will continue its mission of serving Middle Tennesseans for years to come.”

With regard to some things, maybe. But not with regard to health news. The paper has already failed in that mission.”

Finally, for absurdity in robot hype, see a Seattle doc’s You Tube video of how he used a robotic surgical system to fold a paper airplane – and see how the blogger known as The Skeptical Scalpel grounds that hype.

View the original article here

Examples of medical marketing for the week: full body skin cancer scans, robotic hysterectomy

Both of these were sent to me by journalists:

An email pitch letter from a medical group:

Medical Office has First Full Body Scanner to Protect Against Skin Cancer

Dear xxxxx,

We thought that this might make for a very interesting and informative article. With the approach of summer break, this is a time when most people head outdoors. It’s important for people to remember to protect their families against one of the most common forms of cancer today: skin cancer. Current statistics show that 1 in 5 Americans will develop skin cancer in their lifetime.

—- uses the latest technology to detect and protect against skin cancer. They are the only practice in central (could be any state) to offer this system which creates a digital map of the entire body.

Now let’s look at the evidence:  The US Preventive Services Task Force states that “the current evidence is insufficient to assess the balance of benefits and harms of using a whole-body skin examination by a primary care clinician or patient skin self-examination for the early detection of cutaneous melanoma, basal cell cancer, or squamous cell skin cancer in the adult general population.”

The other example came from a journalist who wrote, “Doesn’t it seem particularly exploitative to use a 26-year-old woman’s hysterectomy for this?” The news release/pitch:

Surgeons at xxx Health Center have completed the first robot-assisted surgery in xxxx County.

The first patient was 26-year-old xxx, who underwent a robot-assisted hysterectomy April 13.

Hysterectomies and other gynecological procedures are the first of many robot-assisted surgical procedures that will be offered at xxx.

“We are proud to offer the most high-tech, minimally invasive treatment options available anywhere right here at xxx. Now our patients can benefit from the latest surgical technologies without leaving home,” says (the) president of xxx Health Center.

For advertising disguised as news, see this puff piece in the business section of The Tennessean online, “daVinci robot works miracles.” 

Addendum 5 hours later:  The Nashville Scene website reports, “Tennessean Farms Out Health Section to Hospital Flacks.“  And Paul Raeburn of the Knight Science Journalism Tracker writes:

“The changes come as the Tennessean institutes a paywall for many of its stories. (Newspaper management) said that because of the paywall, “The Tennessean will continue its mission of serving Middle Tennesseans for years to come.”

With regard to some things, maybe. But not with regard to health news. The paper has already failed in that mission.”

Finally, for absurdity in robot hype, see a Seattle doc’s You Tube video of how he used a robotic surgical system to fold a paper airplane – and see how the blogger known as The Skeptical Scalpel grounds that hype.

View the original article here

Dr Topol to med students: "when I was in medical school, the term" digital "was reserved for the rectal exam"

Here are some excerpts of the Baylor College of Medicine commencement address by Dr. Eric Topol, Director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be required reading for anyone involved in health care, which is basically all because everyone of us will be a patient one day.

Eric Topol to medical students: "when I was in medical school, the term" digital "was reserved for the rectal examination".

"Sleep with your cell phone and premium right up there with food and water. We have evolved into a new species of man. We are Homo distractus! "

The benefits of digital medicine are clear to Topol Dr. who shares the story of a patient who has seen last week: "I asked him to put your fingers on the 2 sensors on the back of my iPhone case so I could make her electrocardiogram, ECG — that was normal. And access, among others. Then instead of using a stethoscope to listen to his heart, I used a handheld high-resolution ultrasound pocket and in a minute I could see each facility — heart muscle thickness and heart function, valves, size of 4 Chambers. Why would you ever listen to lub-dub when I can see everything? I have not used a stethoscope for over 2 years to listen to a patient's heart. "

From the YouTube channel of Baylor College of Medicine (BCM): 2012 commencement Speaker, Dr. Eric Topol, May 21, 2012: spoke

Here's the presentation by Eric Topol at the health of Google:

References:

Start address of Baylor College of Medicine by Dr. Eric Topol, Director of the Scripps Translational Science Institute

Comments from Twitter

Trinh Quoc-Dien, MD @ qdtrinh: makes it sound fresh. "@ DrVes: Dr Topol to studs med: when I was in school, the term" digital "was reserved for the rectal exam"

View the original article here

Dr Topol to med students: "when I was in medical school, the term" digital "was reserved for the rectal exam"

Here are some excerpts of the Baylor College of Medicine commencement address by Dr. Eric Topol, Director of the Scripps Translational Science Institute, delivered yesterday, May 22, 2012. This should be required reading for anyone involved in health care, which is basically all because everyone of us will be a patient one day.

Eric Topol to medical students: "when I was in medical school, the term" digital "was reserved for the rectal examination".

"Sleep with your cell phone and premium right up there with food and water. We have evolved into a new species of man. We are Homo distractus! "

The benefits of digital medicine are clear to Topol Dr. who shares the story of a patient who has seen last week: "I asked him to put your fingers on the 2 sensors on the back of my iPhone case so I could make her electrocardiogram, ECG — that was normal. And access, among others. Then instead of using a stethoscope to listen to his heart, I used a handheld high-resolution ultrasound pocket and in a minute I could see each facility — heart muscle thickness and heart function, valves, size of 4 Chambers. Why would you ever listen to lub-dub when I can see everything? I have not used a stethoscope for over 2 years to listen to a patient's heart. "

From the YouTube channel of Baylor College of Medicine (BCM): 2012 commencement Speaker, Dr. Eric Topol, May 21, 2012: spoke

Here's the presentation by Eric Topol at the health of Google:

References:

Start address of Baylor College of Medicine by Dr. Eric Topol, Director of the Scripps Translational Science Institute

Comments from Twitter

Trinh Quoc-Dien, MD @ qdtrinh: makes it sound fresh. "@ DrVes: Dr Topol to studs med: when I was in school, the term" digital "was reserved for the rectal exam"

View the original article here