My Two Cents

The Saga of My Right Foot

noreply@blogger.com (Vicki) — Fri, 06 Nov 2009 22:07:00 +0000

So, I need a new right big toe, or at least a new joint between first metatarsal and the medial cuneiform, which has totally deteriorated, giving me only 5 % functionality. This of course is throwing off the rest of my foot not to mention the rest of my body. It's not stopping me from my long walks and yoga every day, not yet anyway. So I'm thinking of getting it "arthrosurfaced" with a HemiCap since apparently the mess is too great to fix. Anyone every hear of this? It looks like they put a screw in your toe joint. Ouch.

I'm bringing up my toe because it relates to medical records. My long-time podiatrist can't find my old records and has moved practices a couple of times so he doesn't really have some of them. So, I don't know whether this has been getting worse over time, or what. Now, if I'd been empowered to keep my own records, including the x-rays, I'd still have them. Plus, I'd like to think that I'd have been more mindful and not let it get this bad.

All things considered though, this is really minor!

Youth Voices Roundtable

noreply@blogger.com (Vicki) — Fri, 06 Nov 2009 21:17:00 +0000

"How did you hear about the youth group you're in?" That's one of the questions we asked some 20 Montgomery County young people at Wednesday's Youth Voices Roundtable, the third such event held by the county's Commission on Children and Youth of which I am a member. The answer, of course, was "from other kids" for the most part, and from adults personally inviting them into the programs, which ranged from support groups for the children of African, Latin and Asian immigrants to a school-based program for girls to a Jewish youth group. I Twittered a little bit during the event, which you can see in the left hand column here.

The young people sat in the middle of the room (a great space donated by Strathmore Hall) in a circle, with the adults (including the president of the county council, the head of the county's HHS, reps from the school board, etc.) sitting quiety in the back. The kids' conversation was moderated by three of their peers, high school students who are on the commission.

Our original goal several years ago was to learn from the youngsters. Then we discovered that they needed to talk to each other. And, it was clear from Wednesday's event that more of that is needed.

My main takes aways:
Several of the kids said that if their programs didn't exist they would be getting into trouble. One girl even pointed out that crime in her neighborhood has gone up since they closed the YMCA there. We really hope this got through the county big wigs.

We adults think kids are a lot more sophisticated and know more than they really do. One girl even admitted that she learned alot about the "bad things" that could happen to a girl in the world from her support group. With the Internet and TV and teenage attitude, many of us adults have been snowed into thinking kids don't need to be taught basic life skills. Wrong. Or as they say, fail. Yikes. More needs to be done on the basics.

So while the kids kept saying that they only learn from other kids, the conversation did come around to the fact that they need adults, as one boy smiling ly admitted, for organization, direction, knowledge and safety ... but we should be cool or invisible.

All of the kids were really impressive. As I noted in my Twitter comments, the Asian boys were late. When they arrived, one of the African American girls blurted out: "You're in high school? You look so young!" accompanied by some giggling. I was thinking, wow, here we go with steriotypes. But after the meeting, the young lady approached the young man, shook his hand and engaged in a conversation about their high school. Cool young lady!

It would have been interesting to hear more about their families and their perceptions of each other. I'm very curious about inter-ethnic dynamics in this age group. But time was limited. All in all, a great event.

On a personal note, I was also really impressed with the BBYO Jewish group and proud of how much my community does to help its teenagers, even though we are constantly feeling like its never enough.

New Sounds

noreply@blogger.com (Vicki) — Wed, 04 Nov 2009 21:31:00 +0000

How lovely it is walking around my neighborhood every day, saying hello to people bringing their kids home from the bus, walking their dogs (like me), raking leaves. When I run out of NPR podcasts--Wait, Wait, Don't Tell Me, Fresh Air, This American Life, etc. -- I've started listening to New Sounds from WNYC in New York. It's a great mashup of traditional instruments and modern experimentation. The world is one on New Sounds. Sometimes it is really phenomenal, and the host, John Schaefer, is great. When I lived in The City, I went to his live tapings. By listening while I walk, I am experiencing my Bethesda present with my eyes and nose and my past and the rest of the world with my ears. Anyway, check it out.

Patient Participation

noreply@blogger.com (Vicki) — Thu, 22 Oct 2009 20:46:00 +0000

"Medical Records" is huge area. Which records are we talking about? A single doctor's records about individual patients? Prescription records? A hospital's records? Records that are interoperable among doctors, specialities and institutions? Records about individual patients by name? Records about a specific condition? Anonymous records across large populations that can we aggregated and used for valuable research? What functionality should all of these have and how can they be integrated? These are huge issues.

On a simple patient level, I can tell you that no doctor or institution is keeping track of my records in a way that will be useful to me. And, I don't see that happening any time soon.

I've come across a very interesting organization that I recommend you check out: the Society for Participatory Medicine. www.ParticipatoryMedicine.org, which is taking this thought to the next level. The patient is at the center of her/his care. I learned about this organization through the Twittering of a very interesting guy who goes by the handle epatientdave. Check out his recent webcast. http://bit.ly/1cYdKo

Experimenting with Google Health and Microsoft Vault

noreply@blogger.com (Vicki) — Wed, 21 Oct 2009 17:48:00 +0000

My body parts are all over Washington, DC, and probably New York City. Or, rather, x-rays of and test results about my body are scattered who knows where. I'm very lucky; I'm very healthy. I've had the occasional minor health problem: a sprained ankle and a wort. I've messed up both of my wrists at one time or another. All small stuff. But I haven't been keeping track of it. Shame on me. So I'm trying out Google Health and Microsoft Vault, both of which appear to be in Beta form. And, they have serious short comings. Their user interfaces are clunky with very few directions. The excel spread sheet I gave me new primary care doctor is almost better and was definitely easier to make.

Wouldn't it be great if I could have all of my x-rays, lab results, medications, medical procedures, family history all in one place? Strictly from a patient perspective, I think this would be fabulous. It would give me a great sense of control over my health. So, I'll be playing with those products and, I hope, others. To see whether they develop into more useful tools. More in the future...

Why do I care about EHRs?

noreply@blogger.com (Vicki) — Mon, 19 Oct 2009 16:51:00 +0000

Many people have asked why I'm focusing my efforts on electronic heath records. Computerizing medical records has been on my mind for a long time based on personal experiences. I don't know anyone who has died or been badly mistreated as the result of handwritten records, as Denis Quaids children were.

But when I visited an Aunt who was dieing of brain cancer, I discovered that her primary doctor had no idea what the others doctors were doing and couldn't figure it without calling doctors and the pharmacy.
Several years ago, I asked one of my doctors for my records, which he gave me and which were totally unreadable. Useless.
A friend of mine recently had moderately serious surgery at a major university hospital. Over the weekend, she was in terrible pain. Instead of going to a highly praised emergency room close to her home, she drove to the prestigious hospital where she had been treated, thinking that its emergency room could pull up her records and understand better what might be causing the pain. Wrong. The emergency room said it would take two days to get her records ... from their own hospital. This is just plain wrong.
Plus it drives me nuts having to write my family history, etc. every time I see a new doctor and they still don't really have enough information to make fully informed decisions.

Of course, there are a lot of other aspects of health care that drive me crazy: doctors not coordinating their efforts; insurance company and medical institution bureaucracies; the need for patient advocates; the fact that a hospital cannot tell you how much your treatment may cost, etc.

But given my technology background, the medical record area seems appropriate. And despite the huge complications -- security/privacy, interoperability, standards, the cost, etc., this area seems like a relatively simple piece of health care reform where I could have a huge impact. I also think that patients/people need to have more awareness and control over their own health care, which having a formal record could encourage that. But more on that another day.

Physicians' Records Same today as Hippocrates

noreply@blogger.com (Vicki) — Thu, 15 Oct 2009 20:07:00 +0000

So says DAVID BLUMENTHAL in an interview with The New York Times' David Pogue.

http://www.nytimes.com/2009/10/15/technology/personaltech/15pogue-email.html

Great quotes:
"To be a 21st-century physician, to be a 21st-century hospital, we can't record data the same way the Greeks did in 500 B.C. We've gotta move to use the computer to support our work. And that's what we're trying to do."

"Computers can help doctors be better doctors. They can help hospitals be better hospitals. They can help patients take control of their illnesses, not only by making the information available in a reliable way, but by adding tips and reminders and personalized messages about what to do to improve your health, or what tests to order if you're a physician, and what drugs to use or to avoid."

That's just the beginning.

The Importance of Electronic Medical Records

noreply@blogger.com (Vicki) — Thu, 15 Oct 2009 17:49:00 +0000

No matter what you call them -- EMRs, EHRs, etc. -- there is an over-whelming need for electronic documentation that tracks health care. It's important to the individual, the doctor, medical care institutions, research and development organizations, and payment entities. Today, the medical profession, for the most part, is still not even in the 20th century but in the 19th century with handwritten records. This is nuts. At least now a days no one is laughing at the old joke about doctors' legendary bad handwriting. We get it: bad handwriting kills people.

What is more, high-quality medical records could save time, money and lives. They could increase our knowledge many times over. We have the technology. Now we need to will to make them happen.

Fortunately, there are many companies, government agencies and professional associations working toward this.

My goal is to find a role for myself advocating for, and educating consumers about, the immediate, no-excuses implementation of electronic health records. This is an open process at the moment. And, I will keep you posted on what I learn. Stay tuned. All suggestions are greatly appreciated.

Yoga in Wind on the 19th Floor Roof

noreply@blogger.com (Vicki) — Mon, 25 May 2009 15:52:00 +0000

It was wonderful to see the blue sky and wisps of white cloud when I looked up past my hand as I reached up into triangle pose. Bend at the hips, not the waist. Extend. It is surprisingly loud: the air conditioning vents, sirens from the street, helicopters from the distance. The noise was all around me as I stood in tree pose against the wind on the roof of my mother’s building on Manhattan’s York Avenue.

I did my first downward dog in three months this morning. It felt great!

Speedy Trains Should Be a Priority

noreply@blogger.com (Vicki) — Sat, 17 Jan 2009 19:03:00 +0000

I hope this whistle stop train tour bodes well for America rails! Read this Op-Ed piece in today's Washington Post. I totally agree with it. I've always said that it is a shandif that trains in the US are from the 19th century. They've got bullet trains in Shanghai and Japan. It's nice that Biden takes the Amtrak, but has he done anything to fix it? The government pays for highways, it should pay for trains. End of conversation. Hire the train experts!

Fast Train to the 21st Century
By Joseph R. Paolino Jr.Saturday, January 17, 2009; A17
Putting millions of Americans to work and rebuilding our frayed infrastructure are Barack Obama's most pressing priorities when he takes office. He should start by creating a high-speed rail link between Boston and Washington.
More than 20 years ago, in 1988, I traveled as mayor of Providence, R.I., with then-Massachusetts Gov. Michael Dukakis on a new high-speed Amtrak train from Providence to Boston. Our trip took less than half an hour. Unfortunately, the early hopes we all had for high-speed rail in the Northeast have yet to be realized.

http://www.washingtonpost.com/wp-dyn/content/article/2009/01/16/AR2009011603718.html

Reason #1 for Not Wearing High Heels on Airplanes

noreply@blogger.com (Vicki) — Sat, 17 Jan 2009 18:37:00 +0000

This is the correlary to why you should not wear high heels while driving, which I comments on recently.

The captain and crew of this US Airways plane deserve great accolades!! Thank you. I for one feel better about flying knowing that at least some of these people know what they're doing.

Plane Crashes Into Hudson River
Gary Hershorn/Reuters
Published: 20090115
A US Airways plane that took off from La Guardia Airport Thursday afternoon landed in the Hudson River, but all the passengers and crew appeared to be safe.

CES Note

noreply@blogger.com (Vicki) — Sun, 11 Jan 2009 00:03:00 +0000

My company did very well at CES this year. Our digital radio technology was mentioned by Ford in its keynote presentation and received front page coverage and some TV interest as well attention from a lot of reporters and analysts and the general people who come to our new booth in the Central Hall to learn more about real time traffic and other features.

The show is still going on; but I don't work on Saturdays and came home last night. Hurray! The crowds were smaller than last year, but not dramatically lower...at least, not empirically. I was very pumped at the show. So many nifty gadgets and enthusiasm for the capabilities of future products. It's challenging coming home to friends telling me about lay offs and work-place issues. But I really believe we have to be positive or we'll make the financial situation worse.

Vegas itself is facing a lot of challenges. Billion-dollar projects have been scaled back or cancelled. I stayed at Treasure Island, which was just sold by MGM/Mirage to help pay for it colossal City Center project. There is one particially built structure that has been haulted, where the Frontiere used to be, i think.

For that matter, we have a hole for sale in Bethesda, where someone started building a house and just stopped, leaving a gapping dig site.

I've put up a slide show that CES posted about photos from the show. It's in my left column

Message from the Wise Philanthropy website

noreply@blogger.com (Vicki) — Mon, 29 Dec 2008 17:13:00 +0000

The following is an essay from a good friend of mine who specializes in family philanthropy consulting, Richard Marker.

The community was traumatized – they had managed to absorb political reversals, terrorism, and general economic deterioration. As difficult, upsetting, disconcerting, and challenging each of this succession of crises had been, they had always been by outsiders. This crisis was of a different sort altogether. A powerful insider in the financial community had been indicted; his financial institution bankrupt; huge sums had been lost by individuals and by institutions. This was too close; it cut too deep, it belied trust and loyalty; it was nothing less than a trauma.No, this was not about a Mr. Madoff, and the country was not the United States. This is the story of Argentina.... http://wisephilanthropy.blogspot.com/

Green Gift Wrapping

noreply@blogger.com (Vicki) — Fri, 26 Dec 2008 15:44:00 +0000

I'm very proud of the way we are wrapping gifts this holiday season. Instead of paper, we are folding tea towels and bandannas around them. Instead of little bags, we're putting presents into Chico shopping bags. So not only are we not wasting paper, we are giving extra gifts. Only buy these tote bags from Chico's website: http://www.chicobag.com/. They are much more expensive else where.

Benjamin Button--Read The Washington Post

noreply@blogger.com (Vicki) — Fri, 26 Dec 2008 15:38:00 +0000

I was going to write a review about 'The Curious Case of Benjamin Button', but I think Ann Hornaday at The Washington Post hit the nail on the head! Read her review.

http://www.washingtonpost.com/wp-dyn/content/article/2008/12/24/AR2008122401879.html

Chanukah Candles Observed by Santa Claus

noreply@blogger.com (Vicki) — Thu, 25 Dec 2008 23:03:00 +0000

One Reason for Not Wearing High Heels When Driving

noreply@blogger.com (Vicki) — Thu, 25 Dec 2008 22:51:00 +0000

It would be best to wear sensible shoes when air-lifted out of your car due to a flash flood.

http://www.myfoxdc.com/myfox/pages/News/Detail?contentId=8129587&version=23&locale=EN-US&layoutCode=TSTY&pageId=3.2.1

http://www.baltimoreexaminer.com/local/122408emswatermain.html

Meaning of Chanukah

noreply@blogger.com (Vicki) — Tue, 23 Dec 2008 11:48:00 +0000

Read this excellent article about Chanukah written by Rabbi Sid Schwarz. http://www.washingtonpost.com/wp-dyn/content/article/2008/12/19/AR2008121902515.html

One of our 48Hour Videos is going Viral

noreply@blogger.com (Vicki) — Tue, 23 Dec 2008 11:03:00 +0000

http://www.countgore.com/gore/newblood.htm

Brunch in Bethesda

noreply@blogger.com (Vicki) — Sun, 16 Nov 2008 19:18:00 +0000

The Louisiana Kitchen & Bayou Bar serves up a fabulous brunch. It's a traditional poached eggs with hollandais sauce brunch with a modern Louisiana twist. Plus pretty good beignets. I had poached eggs Sardou with a wonderfully herbal cream of spinach, very lightly creamed, served on artichoke bottoms with a light biscuit and seasoned potatoes. My husband tried the eggs Benedict, which he loved too. You can also choose from crab and craw fish enhanced eggs and omelets. We saw the house special french toast being served to a table next to ours and were jealous. It looked absolutely luscious, topped with large strawberries. The beignets were good, almost as good as Cafe De Monde in the French quarter. If you don't like your coffee very dark and a little bitter, don't order coffee. I loved it; but it wasn't the right taste for my husband. Even the coffee without chicory didn't work for him.

Here's a marketing success story. Somewhere my husband picked up a coupon for the beignets and ever since has been talking about trying the restaurant, which is walking distance from our house, like zillions of other restaurants we can walk to. It's always hard to know where to go next. And, a creature of habit. I like to go to the same Japanese restaurants every night.

The decor and louisiana jazz music totally remind me of New Orleans. All that was missing was the rain. We arrived just after the restaurant opened and had our pick of tables. But quickly the place filled up with families and large groups. This always makes me happy because I like to see my neighborhood's restaurants prosper. So try it:

The Louisiana Kitchen on Cordell Street in Downtown Bethesda. They have take out too!

Yes We Did. The Experience of Winning Hurray!

noreply@blogger.com (Vicki) — Mon, 10 Nov 2008 03:00:00 +0000

David Letterman: "Barak Obama is our new President. And, I think I speak for most Americans when I say, 'Mind if he starts a little early?'"

November 5, 2008, 11:00 PM, the Marriott Hotel in Rockville, Maryland. A room full of Democrats who had just spent the last few months campaigning in Virginia.

It's Great to Have a Smart President. Halaluyah!

noreply@blogger.com (Vicki) — Mon, 10 Nov 2008 01:49:00 +0000

You have got to read Nicholas Kristof's OPED piece today. It says it all (plus some gross stuff about Nero that I wish an editor had cut out).

Op-Ed Columnist
Obama and the War on Brains

By NICHOLAS D. KRISTOF
Published: November 9, 2008
Barack Obama’s election is a milestone in more than his pigmentation. The second most remarkable thing about his election is that American voters have just picked a president who is an open, out-of-the-closet, practicing intellectual.
Maybe, just maybe, the result will be a step away from the anti-intellectualism that has long been a strain in American life. Smart and educated leadership is no panacea, but we’ve seen recently that the converse — a White House that scorns expertise and shrugs at nuance — doesn’t get very far either.

Yes, We Can! History was made last night!

noreply@blogger.com (Vicki) — Wed, 05 Nov 2008 13:17:00 +0000

I'm so happy and tired. I spent all day yesterday in Richmond, going door to door in the rain, getting out the vote. Here are photos of some of the team I went with.

We Marylanders had a lot to do with the victory in Viriginia -- how sweet it was last night at the Montgomery County rally to hear that Virginia joined the future and went Democratic!!! We were all elated and then the announcement that Obama had really, really been elected president of these United States. It was beyond belief. And, me, being me, am worried, of course. Obama has to live up to our expectations and we have to help him and our country. The most important thing is that the infrastructure that Obama built for his election needs to hold and work for the nation just as hard as it did for the presidency. He, and we, have inherited crises created by the republicans (the republicans, not just George Bush). There is a lot of work ahead of us.

Danika's fabulous Halloween Pumpkin of Rapper "Lil Wayne"

noreply@blogger.com (Vicki) — Sat, 01 Nov 2008 00:33:00 +0000

Peregrine Falcon in Columbia, Maryland

noreply@blogger.com (Vicki) — Sat, 01 Nov 2008 00:16:00 +0000

I hear a loud chirp as I climbed out of my Honda Accord this morning. It sounded like a nice small bird, but it captured my attention. I looked up. And sure enough there was a huge bird sitting atop my five-story office building in Columbia, Maryland. Here s/he is.