Posts tagged ‘Postoperative Report’

What We Talk About When We Talk About Structured Data (part 1)

Still trying to find that needle...

Sometimes it feels like my job wholly consists of talking about structured data. I give definitions and abstract examples – but it’s not easy to help people understand the real benefits of it. And so, as I try to find the best way to get my point across, I often think of real world examples of how structured data is useful in our daily lives and why it tends to be preferable to unstructured, narrative text.

With that in mind – let’s go out to the ball park!

THAT's the Chicago way!

Baseball. America’s Past Time. The Sweet Science. City of Lights. The Ghost and the darkness.

Okay, I’m not the biggest baseball fan. I will watch playoffs and world series. But I do know that a lot of baseball is about numbers: strike outs, home runs, bases stolen, RBIs, wins, losses, saves, ERAs, pitches thrown. Each of these play a crucial factor in determining how well your team is doing or how a player is perceived by his fans. And, following theories like those laid out in Moneyball, these metrics can even determine who will be signed on to your favorite team.

So what does this have to do with structured data? Glad you asked!
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August 18, 2010 at 3:59 pm 2 comments

Common Language: The Rise of Standard Formatting for Surgical Reports

Gottfried Wilhelm von Leibniz

Gottfried Leibniz. That name doesn’t mean much to most people, outside of math nerds with a penchant for historical trivia. Leibniz is credited with simultaneously creating calculus at the same time of Sir Isaac Newton. Years of debate ensnared the scientific community as patriotic mathematicians of Germany and Britain argued for their respective countrymen. Each camp tried to prove the independent, solitary insight needed to develop calculus solely rested with one man or the other – but were unable to find definitive proof that Newton or Leibniz had been the one to originally conceive of this new field of mathematics. There are suggestions that Leibniz was inspired by some of Newton’s works but, as there’s still too many gaps in the works of Newton that would have been available for Leibniz to consult in order to develop calculus, there’s no substantial proof that Leibniz plagiarized Newton’s work.

Rob's attempt to innovate calculus was met with much less enthusiasm

So what happened then? Perhaps this is an example of Rupert Sheldrake’s pseudo-scientific theory of “morphic resonance” in which behavior is somehow transported across great geographical distances between similar types of animals or people. And while it is always interesting and neat to consider such a possibility – an example of some innate telepathic or cultural osmosis that seems to exist on a cellular level between people – it’s rather unlikely. How, then, did this rise of a new way of thinking occur at the same time in two different places? How were two men able to discover the same mathematical principles without being in collaboration? And what does any of this have to do with surgical reporting?

To put it simply – great minds think alike. The fact of the matter is that both Newton and Leibniz recognized a need for something in the world – in this case, the lack of a particular mathematics field that could be applied to many facets of our lives and used to explain so much of what we don’t understand. It is this same ability for multiple people, unrelated and independent of one another, to see the writing on the wall in the medical community and recognize the absolute need and demand for standardized and structured surgical reporting.
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June 23, 2010 at 10:22 am Leave a comment

Interview with Dr. Jared Ament: A New Way to Tell an Old Story

Dr. Jared D. Ament recently completed clinical research fellowships at Harvard Medical School’s Massachusetts Eye and Ear Infirmary (MEEI) and at the University of Massachusetts Medical Center (UMass) in surgical outcomes. He has worked with Dr. Dohlman (MEEI) and Dr. Black (Brigham and Women’s Hospital) for 3 years now and with Dr. Richard Moser (UMass) for the last year. His MD is from the Medical School for International Health, a collaborative initiative between Ben-Gurion and Columbia Universities. His MPH is from the Harvard School of Public Health. He is adjunct faculty at Harvard Medical School’s department of Population Health and Epidemiology and has specific interests in cost-effectiveness research, international surgery, surgical outcomes, and medical education. He is currently a surgical resident at UMass.

How did you become interested in medicine?

I was a kid who was fascinated by the workings of the body. I was also very involved in martial arts and interested in the inherent mechanics and physiology. And then, as a teenager interested in culture and public health, I traveled extensively to non-industrialized countries, volunteering in all sorts of public health efforts. I guess I just found a niche where working with people from many cultures, coupled with my fascination for human physiology, struck a cord. The left side of the equation seemed to equal “medicine” on the right.

And how did you decide on being a surgeon, specifically?

Many people just know; for a select minority, however, it’s a struggle between the operating rooms of surgery and the diagnostics and offices of internal medicine (and its specialty fields). I always loved surgery and truly knew that the operating room was where I belonged. Yet, I struggled, as the detective work and thorough understanding of bodily functions was tantalizing. My conclusion, however, was that a good surgeon should, first and foremost, be very strong, clinically. They are, too, diagnosticians, physicians, empathic healers, that have dedicated significant time and training to perfecting a tactile skill in addition to, and very much in parallel with, their medical skills. I am still in training but truly enjoy both the clinic and operating room. I need both. I enjoy the time with my patients; the interaction; the teaching and learning that takes place (bi-directional); collaborating with colleagues (surgical and medical); and hold the operating room, the unconscious patient and the delicate work to be performed with the utmost of respect.
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June 22, 2010 at 1:22 pm 2 comments

An Overview of OpNote & Some Site News

Below you will find a video that introduces the concept, design and purpose of the product we’ve been working on for a while – the mTuitive OpNote.

Over the next few weeks, there will be some changes to this blog. Nothing is going away or being replaced. However, as we roll out our new product, the blog will be more of a hybrid showing various aspects of OpNote, including videos showing how to perform various tasks with it, along with the pieces we’ve been posting about transcription, Health IT and all other manner of medical nerdery. The posts we write tend to show off our thinking and philosophy on how information technology should be used in the medical field – and we believe the OpNote embodies that way of thinking. OpNote is our philosophy in practice and we hope you like what you see.

May 7, 2010 at 1:41 pm Leave a comment

Relativity in Reporting

How long does it take a surgeon to complete a postoperative report?

It seems like a straightforward question and it’s been one of our main focuses as we’ve developed the OpNote, our electronic postoperative reporting product.  In order to ensure adoption by users, we know that we can’t tax the user’s (in this case, a physician’s) time any more than they already spend on reporting.  So we had to determine how much time physicians spend generating their own postoperative reports.  This was mainly done through anecdotal means – speaking with various surgeons and asking them how long it takes for them to complete a report.

And that’s when we learned something interesting.  Surgeons would tell us it would only take 30 seconds to 5 minutes to complete their report, depending on the level of complexity of the procedure.  But is that accurate?  As we gathered information and stories of postoperative reporting – we noticed that the way physicians think about report completion may not be as correct as they think.

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April 1, 2010 at 2:50 pm Leave a comment

Introducing the OpNote Consultants: Carl Brown, MD, MSc, FRCSC

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

Dr. Carl Brown completed medical school at McMaster University in 1995 and his general surgery training at the University of Calgary in 2003.  He subsequently worked as a general surgeon at the Peter Lougheed Centre in Calgary.  In 2004, he moved to Toronto to train as a sub specialist in Colorectal Surgery. Concurrent with his fellowship, Dr. Brown completed his master’s degree in clinical research at the University of Toronto.   In 2006, he joined the surgical staff of St. Paul’s Hospital in Vancouver.

Dr. Brown is the chairman of the Research and Outcomes Evaluation Committee at the British Columbia Cancer Agency and an active member of the Colorectal Cancer Outcomes Unit. He is a member of the Surgical Oncology Network of British Columbia Executive. The goal of these groups is to improve the outcomes of patients with colorectal cancer through research initiatives.

Dr. Brown is the assistant program director of the general surgery residency program at the University of British Columbia. He coordinates the Surgery Leadership Program for general surgery trainees.  Over the past three years, Dr. Brown has published several studies on surgery for colorectal cancer, the ileal pouch procedure and surgery for Crohn’s disease. Furthermore, he has taught courses in laparoscopic colorectal cancer surgery.

How did you get interested in medicine?

I was always interested in science but, more importantly, I like interacting with people and helping people.  While it may seem cliché, [medicine] has turned out to be everything I had hoped it would be.  I do get to help people every day.  There’s never a day that I go home after work without feeling satisfied that I’ve accomplished something.

Wow – that’s great.

Yeah, it’s really true.  You know, it sounds kind of clichéd and maybe even a little cheesy, but it is so true.

What attracted you to surgery?  What made you go with that specialty out of all the possible paths in medicine?

Firstly, I’m a fix-it kind of guy.  I like to fix things.  It’s always been something I’ve been fairly strong at – growing up in a small town, we always took it upon ourselves to fix things around the house.   A lot of what we do in medicine is tweaking things: giving a little medication to make someone feel a little bit better.  And that is very important.

But I like the “fix”.  I like the stress and the pressure of having someone who has a life threatening illness and taking on the incredible responsibility and trust of that person by operating on them.  Many times what I do cures the person of that problem.  It’s very gratifying – very immediate.  It’s sort of what I think medicine’s all about.

How did you first hear about mTuitive and the OpNote product?

I’m an academic surgeon at a major Canadian university.  My main research interest for over seven years now has been synoptic reporting and improving processes of care in surgery.  About 6 years ago I published an article in the journal Surgery about synoptic reporting and its benefits.  It’s always been an interest of mine.

Concurrently, as I’ve worked through my career, I’ve become more interested in cancer.  There’s a big push to have synoptic reporting in cancer surgery – much like there is excellent synoptic reporting in cancer pathology.  I feel strongly that [synoptic reporting in surgery] is a simple thing that we can add that can potentially improve patient care and save lives.

Through my work with the provincial organization in British Columbia I was introduced to the mTuitive products.  I saw it as a possible solution to a lot of our problems.

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March 26, 2010 at 4:18 pm Leave a comment

Introducing the OpNote Consultants – Dr. Seth Goldberg

While creating our surgical reporting product, the OpNote, we at mTuitive have been working with many highly skilled surgeons.  These surgeons are from a diverse group of specialties and backgrounds and help to shape the future and efficacy of the OpNote.  We’re introducing these consultants to all of you in the coming weeks.

After 27 years as an otolaryngologist/facial plastic surgeon in Rockville, MD, Dr. Seth Goldberg launched a new career as a health care consultant specializing in clinical information technology development, utilization management, continuous quality improvement, and risk management. He conducts accreditation surveys of outpatient medical facilities for the Accreditation Association for Ambulatory Health Care. Dr. Goldberg holds board certifications in Otolaryngology-Head & Neck Surgery, and Facial Plastic and Reconstructive Surgery.

He earned his B.S. degree in Molecular Biophysics and Biochemistry from Yale University, and his M.D. degree from Tufts University School of Medicine. He recently received his Masters of Medical Management degree from Carnegie Mellon University. Washingtonian Magazine and Washington Consumers Checkbook have included him in their list of Top Doctors.

In conjunction with his solo clinical practice, Dr. Goldberg was Chief of Otolaryngology at Holy Cross Hospital in Silver Spring, MD, and Shady Grove Adventist Hospital in Rockville, MD. He also served as a member of the Peer Review Committee of the Montgomery County Medical Society and as a peer review consultant with the Delmarva Foundation, Medical Mutual Liability Society of Maryland and the Medical Chirurgical Society of Maryland.

How did you get your interest in medicine?

I’m at the leading edge of the baby boom generation and my role model was – and we can joke about this – it was the TV show “Marcus Welby, MD.” He was a very respected individual and it was clear, back in the sixties, that physicians were highly respected members of and contributors to the well-being of  society.  So I think that’s what originally piqued my interest.

There were other factors, of course – I excelled at science and math.  I had an inquiring, experimental mind – I worked as a lab assistant for one of my biology teachers in addition to taking Advanced Biology as an elective in high school.  I taught tomato plants to say, “feed me, Seth.”

(Laughs)

Once I got into college, I fast tracked into medicine – that seemed to be the thing to get into at the time.  So I did my pre-med and the process for getting into medical school was actually pretty easy.  I had an interview at Tufts that consisted of the interviewer informing me that they had already decided to admit me.

(Laughs) So then you clearly felt like “I nailed it!”

(Laughs) Basically, yeah – I felt like I had nailed it, right.  Also, at the time, there was this other little thing called the Vietnam War.  I had a high lottery number, or I guess it was actually a low lottery number.  So there was only one other choice and that was be cannon fodder.

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March 17, 2010 at 10:25 am Leave a comment

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