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You Can’t Tell the Batters Without a Scorecard

If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately these approaches to comparing physicians’ skills are only available to hospital… Continue reading You Can’t Tell the Batters Without a Scorecard

What If My CHA₂DS₂-VASc Score Is One?

There is nothing simple about atrial fibrillation; it is a complicated, often overwhelming disease, both for patient and physician. One question that invariably comes up early on is the question of prophylactic anticoagulation for prevention of stroke. Who should receive anticoagulation? Which anticoagulant? How should anticoagulation be handled around the time of surgical procedures, or… Continue reading What If My CHA₂DS₂-VASc Score Is One?

After Life

Jonathan closed his eyes, died, and immediately woke up in a place that was, he assumed, Heaven. He could hardly contain his astonishment. A lifelong rationalist (a physicist to boot!), he was fully prepared for the eventuality that death was the end. But here he was — moments before occupied with the mechanics of dying… Continue reading After Life

Reading About Steve Jobs

I am interested in the history of computer technology and over the last couple months have read a lot about Steve Jobs. To be specific I read Walter Isaacson’s Steve Jobs, Brent Schlender’s Becoming Steve Jobs, and a book published back in 2001, Alan Deutschman’s The Second Coming of Steve Jobs. To get the point of… Continue reading Reading About Steve Jobs

Index Verborum Prohibitorum

The Catholic Church for centuries maintained a list of banned books, the Index Librorum Prohibitorum, only abolishing it in 1966. Governments, particularly fascist ones, also have had a pronounced tendency to ban books for moral, religious, or political reasons. Such censorship is a repugnant form of thought control. It is no surprise that the fascist… Continue reading Index Verborum Prohibitorum

Introducing EP Calipers

Ever since the 1990s, when computer-based electrophysiology (EP) systems were introduced, HV intervals and ventricular tachycardia cycle lengths have been measured in the EP lab by electronic calipers — simple but accurate measurements accomplished on-screen using a track ball or a mouse. Despite this, physicians still often carry a physical pair of calipers, perhaps preserved… Continue reading Introducing EP Calipers

EP Mobile Update Version 3.6 for Apple Devices

The reviewers at the Apple iTunes App Store have approved the revised version of the EP Mobile app. For information on why the app needed to be revised, see my earlier posts on the subject. I removed the drug dose calculators (note though that the Warfarin Clinic module was not removed), but added detailed drug… Continue reading EP Mobile Update Version 3.6 for Apple Devices

Update on EP Mobile and Apple #2

As some of you are aware, the Apple App Store rejected an update to the EP Mobile app based on the presence of drug dose calculators in the app. The App Store guidelines state: 22.9 – Apps that calculate medicinal dosages must be submitted by the manufacturer of those medications or recognized institutions such as… Continue reading Update on EP Mobile and Apple #2

How to Build a Better Electronic Health Record Part 27 — Modularity

Editors note: This 27th entry in our web series on EHR design is excerpted from Electronic Health Record Software: Principles and Practices, 3rd Edition, by Paul Lockhart and Janet Twombley-Chu, published by Addison Wesley, June 2089. 3378 pages. ISBN: 103-978-1-4919-0498-5. Reprinted by permission. Amazon listing [1]. Chapter 7 EHR Modularity 7.1 A History Lesson In… Continue reading How to Build a Better Electronic Health Record Part 27 — Modularity

All the President’s Tapes

Richard Nixon’s downfall, a.k.a Watergate — a word whose suffix has become a part of the English language, has always fascinated me. In the summer of 1973, poised between graduation from college and the start of medical school, I spent an inordinate amount of time in front of the television watching the Senate Watergate hearings.… Continue reading All the President’s Tapes