Enoch Choi, M.D.
Category: Health Technology
Posted by: enochchoi
I'm excited about the prospects for this health device after chatting with the founder after a IFTF consulting gig we did together:
Zume Life Inc. is developing an innovative personal health management
solution, focused on empowering individuals to take control of managing
chronic health conditions. We would appreciate your help to guide our efforts
by providing input through participating in a Pilot Test.
The pilot test will begin around the end of December 2007 and will last for
three months. Set-up and occasional questionnaires might take an average of
fifteen minutes each week. Pilot Testers need to be adults living in the San
Francisco Bay Area, are actively managing a chronic disease of: asthma,
hypertension, diabetes, and live busy lives. For more information call
408-878-6089 or visit www.Zumelife.com and follow the "SignUp" links.
If you choose to participate, you will have better control of your health a be
helping make the world better for a lot of other people.
Technorati Tags: education, health, Health2.0, medicine, technology
Category: Infectious Disease
Posted by: enochchoi
www.flickr.com
This is a Flickr badge showing photos in a set called CDC flu shot influenza immunization blogger webinar 2007. Make your own badge here.
The CDC held their 2nd annual webinar today, reaching out to mommybloggers to ask for help getting the word out about the need for flu shots. Here are screenshots...
It was sooooo much better than last year's. This year a mother who's a communications person at the CDC talked through slides and voiceover, rather than last year's pristinely uniformed physician talking heads on video. Yeah, I know, I'm a doc, but they were so stiff last year. This year they got the message through loud and clear: Go Get Flu Shots! I took notes that you can click thru to take a look at...
Why care about flu? It's miserable to experience the flu, trust me, I had it last year in June in Singapore (winter in the southern hemisphere you know), and had fever, chills, muscle aches, and hallucinations. Many elderly and children/infants die of flu and subsequent pneumonia. It's no laughing matter, it's much worse than a simple cold.
Who need the flu shot: everyone benefits, but those at high risk are those over 50 and under 5. Those under 6 months unfortunately can't get the shot, so it's even more important for household contacts to get it to protect these wee little ones. Others at high risk include those with chronic medical conditions, pregnant women, healthcare and childcare workers.
Almost 3/4 of the US population is recommended to get the flu shot, 220 million, but less than 1/2 of them get it because they don't realize the importance. This year isn't like last year, we have plenty of shots this year, and everyone who asks can get it.
Reasons why people think they don't need it:
- other people can get it and I'll be protected (unfortunately this immunization is not used by enough people to give you and your family herd immunity, you can get it)
- the flu won't kill me (but it could kill a loved one of yours who's at high risk)
- my doctor didn't recommend one (some physicians forget-- trust me, I know)
- flu shots will give my kids autism (no link between flu shots and autism)
- flu shots will give me the flu (some people get a cold at the same time as getting the shot, it wasn't the flu, the flu's much worse... the flu shot only gives mild flu-like symptoms, and infrequently)
Ask a friend who's had influenza, like me. We'll tell you how miserable we were. Almost a quarter of a million people are hospitalized for this every year, and 36,000 people die from it. There's still time. It takes 2 weeks for protection to kick in, and the flu season peaks in January to February, go get your shot now!
Technorati Tags: cold, cough, flu, influenza, shot, immunization
The holidays are a delightful time for enjoying great food with family and friends. Entirely too delightful for our waistlines, unfortunately. The most troublesome thing about holiday weight gain is that it's really hard to get the pounds off after you've put them on. Here are some tips to help keep off the pounds:
- Eat with your eyes, not with your fingers. Much of the enjoyment of a meal comes from seeing a beautiful spread and the wonderful aroma that wafts from the table. Try to focus on how much you enjoy the beauty and scent as you eat. Slow down and savor your mouthfuls.
- Enjoy your company. The more you can focus on fun conversation with friends and family, the less you'll dig in.
- Take small portions. There's so much to try, limit yourself to small portions of your favorite dishes. Chefs know that you get all of the pleasure from food from the first 3 bites. After that, it's just about filling you up. If you feel stuffed, you've eaten too much.
- Use a smaller plate. Many people love to see a full plate. If your plate is smaller, you can get the same enjoyment with less puttin' down.
- Watch out for high-calorie drinks. Some folks do really well with limiting their diet and forget how many calories are in juice, wine and beer. These are empty calories without much nutritional value, however enjoyable they are. Try not to overdo it and you'll help slim yourself.
Now, if you've already overdone it, as I had over Thanksgiving, here are some ways to shed the pounds:
- Commit to exercising more than you eat. What does that mean? Weight loss comes when you burn more calories than you consume. The more you walk, in excess of the calories you swallow, the more you'll lose.
- Lose weight gradually. Many folks yo-yo between extremely restrictive diets that are so low in nutrition they're harmful, then bounce back up to gorge themselves. That's a sure way to harm yourself by both gaining weight and depleting your body of nutrition. Make a goal of 1/2 a pound a week, which is sustainable by most people.
- Limit your portion size. Most cafeterias serve such gigantic portions that I've taken to eating half of my lunch at noon then the rest of the half for dinner. If you keep busy enough, you can distract yourself from the nagging hunger. One way to feel full is to drink lots of water, to a goal of at least five 8 ounce glasses a day. That helps be ward off the hunger.
- When you're lonely, pick up the phone, not the fork. One thing i learned from Dr. Roger Gould's "Shrink Yourself" online program is that I eat when I miss my wife, after a long day in clinic and she's already asleep with the kids. Instead of snacking, I've tried to chat with friends who are similar night owls and that's helped avoid the nighttime munchies.
- Take a walk. You'd be surprised at how much it helps to take a walk before work or at breaktimes. Regular exercise can increase your muscle mass and metabolic rate so that you burn more calories even when you're sedentary at work, at rest at your desk. Try it out!
Hope these tips help you out, and good luck over the coming holidays!
- Eat with your eyes, not with your fingers. Much of the enjoyment of a meal comes from seeing a beautiful spread and the wonderful aroma that wafts from the table. Try to focus on how much you enjoy the beauty and scent as you eat. Slow down and savor your mouthfuls.
- Enjoy your company. The more you can focus on fun conversation with friends and family, the less you'll dig in.
- Take small portions. There's so much to try, limit yourself to small portions of your favorite dishes. Chefs know that you get all of the pleasure from food from the first 3 bites. After that, it's just about filling you up. If you feel stuffed, you've eaten too much.
- Use a smaller plate. Many people love to see a full plate. If your plate is smaller, you can get the same enjoyment with less puttin' down.
- Watch out for high-calorie drinks. Some folks do really well with limiting their diet and forget how many calories are in juice, wine and beer. These are empty calories without much nutritional value, however enjoyable they are. Try not to overdo it and you'll help slim yourself.
Now, if you've already overdone it, as I had over Thanksgiving, here are some ways to shed the pounds:
- Commit to exercising more than you eat. What does that mean? Weight loss comes when you burn more calories than you consume. The more you walk, in excess of the calories you swallow, the more you'll lose.
- Lose weight gradually. Many folks yo-yo between extremely restrictive diets that are so low in nutrition they're harmful, then bounce back up to gorge themselves. That's a sure way to harm yourself by both gaining weight and depleting your body of nutrition. Make a goal of 1/2 a pound a week, which is sustainable by most people.
- Limit your portion size. Most cafeterias serve such gigantic portions that I've taken to eating half of my lunch at noon then the rest of the half for dinner. If you keep busy enough, you can distract yourself from the nagging hunger. One way to feel full is to drink lots of water, to a goal of at least five 8 ounce glasses a day. That helps be ward off the hunger.
- When you're lonely, pick up the phone, not the fork. One thing i learned from Dr. Roger Gould's "Shrink Yourself" online program is that I eat when I miss my wife, after a long day in clinic and she's already asleep with the kids. Instead of snacking, I've tried to chat with friends who are similar night owls and that's helped avoid the nighttime munchies.
- Take a walk. You'd be surprised at how much it helps to take a walk before work or at breaktimes. Regular exercise can increase your muscle mass and metabolic rate so that you burn more calories even when you're sedentary at work, at rest at your desk. Try it out!
Hope these tips help you out, and good luck over the coming holidays!
11/27: Grand Rounds is here!
Category: Health blogs
Posted by: enochchoi
The weekly roundup of the best blog posts of medbloggers is here! Thanks to Nick for the MedScape Pre-Rounds interview... I've felt more generous as I realized that caring for your kids on vacation is harder than your usual life, and after noodling on the submissions over the last 3 days, I can't find a theme, so I've included every post submitted to me, in chronological order, other than my favorite post:
Walter highlights my favorite post of the week, Saline Nasal Irrigation More Effective than Spray for Chronic Sinus Symptoms and why my fav? According to a new study in the latest issue of the Archives of Otolaryngology — Head & Neck Surgery, saline irrigation treatments show greater efficacy versus saline spray for providing short-term relief of chronic nasal and sinus symptoms. It confirms what I've been telling folks for ages, that you have to get the mucous off of the membranes before you can get any medicine to be absorbed.
Jonathan Pletzke discusses trying out a "class II medical device" Migun Health Bed that delivers a decent massage.
Linda Regan comments on how "Looks can be Deceiving - Gender Bias" where a major academic journal in emergency medicine publishes an article with overt gender bias.
Christine helps people get "ready" for a doctor's visit.
Mark A. Rayner found this in "How Isaac Newton Lost His Marbles" which provides a short circular description of the history of medicine.
Alvaro finds interest in how positive psychology is adopting a more science-oriented approach, including randomized studies, and asks, can we enhance our happiness and health by nurturing gratitude?
Nancy L. Brown of Teen Health 411 advises How to increase unintended pregnancy, and sobs at the fact that U.S. is #1 in Chlamydia Cases.
David C. Harlow heralds what he expects to be a CMS plan for P4P for physician services since they're proposing this for hospital reimbursement now, with a few years of pay-for-reporting for hospitals as well as talks up EHRs and PHRs, and thoughts on secondary uses of PHI.
Gerry Pugliese encourages us to wash our hands, a great idea.
adi shares with us "Love in the Time of Katrina."
Mother Jones writes about borderline personality disorder.
Christian writes using the boxing metaphor as a tool to figure out which of two risk factors is most important for health - body fat or passive smoking, "Big risk factor contest".
Amy Tenderich writes about Feeling Displaced, regarding a whole bunch of adults with Type 1 who were never children with diabetes -- and many who were but are now grown-up -- are yearning for an organization of our own.
An anonymous blogger is writing a Medications For Pain Series: Narcotics and Opiates.
Sid Schwab of Surgeonsblog writes of what cancer looks like.
David E. Williams at MedTripInfo spent last week touring hospitals in Korea and have done a 9-part diary.
Michael Segal speculates on a link between fidgeting and weight loss.
Kenneth F Trofatter at "Fruit of the Womb" wrote about "Late Preterm Birth - Patient and Provider Education Still Needed". The misperception that it is okay to deliver a few weeks early is very pervasive among both patients and providers and continues to result in tragedies and near misses in neonatal outcomes.
Toni Brayer writes of how primary care is being reimbursed less and less in a reimbursement environment tailored towards paying for procedures.
Paul Auerbach writes of what he's personally experienced recently with his retinal detatchment, with its application to wilderness medicine.
Jeremy Joslin, MD wrote at "Medicine for the Outdoors" about a technique for reducing shoulder dislocations.
Bongi writes of times he's operated on lacerated inferior vena cavas.
Terry tells an anecdotal story about the amnestic qualities of Propofol on my husband after his colonoscopy.
Susan Palwick is a volunteer ER chaplain, wrote this post in a response to a recent tragic suicide at a hospital in my area.
Barbara tells A Story About Chronic Back Pain and a Relationship Gone Sour: Kate and Frank, where we like to think that we can rise to the occasion; but when that occasion is chronic pain, some people sink. This is a story about a couple whose relationship turned sour when back pain became too much for them to bear.
Dr. Val brings a short vignette about her personal "mixed feelings" about breast augmentation.
Finally, I'd encourage you all to check out the forums here at MedHelp, where almost 5 million a month find answers they're looking for, from trusted doctors. The docs here are like bloggers in that they're exposing the details behind what goes on in their minds, just as bloggers make more transparent their view into health & medicine.
Next week's host is http://gcgeorge.net/ and I encourage you all to head over there to participate as enthusiastically as you've done here...
Walter highlights my favorite post of the week, Saline Nasal Irrigation More Effective than Spray for Chronic Sinus Symptoms and why my fav? According to a new study in the latest issue of the Archives of Otolaryngology — Head & Neck Surgery, saline irrigation treatments show greater efficacy versus saline spray for providing short-term relief of chronic nasal and sinus symptoms. It confirms what I've been telling folks for ages, that you have to get the mucous off of the membranes before you can get any medicine to be absorbed.
Jonathan Pletzke discusses trying out a "class II medical device" Migun Health Bed that delivers a decent massage.
Linda Regan comments on how "Looks can be Deceiving - Gender Bias" where a major academic journal in emergency medicine publishes an article with overt gender bias.
Christine helps people get "ready" for a doctor's visit.
Mark A. Rayner found this in "How Isaac Newton Lost His Marbles" which provides a short circular description of the history of medicine.
Alvaro finds interest in how positive psychology is adopting a more science-oriented approach, including randomized studies, and asks, can we enhance our happiness and health by nurturing gratitude?
Nancy L. Brown of Teen Health 411 advises How to increase unintended pregnancy, and sobs at the fact that U.S. is #1 in Chlamydia Cases.
David C. Harlow heralds what he expects to be a CMS plan for P4P for physician services since they're proposing this for hospital reimbursement now, with a few years of pay-for-reporting for hospitals as well as talks up EHRs and PHRs, and thoughts on secondary uses of PHI.
Gerry Pugliese encourages us to wash our hands, a great idea.
adi shares with us "Love in the Time of Katrina."
Mother Jones writes about borderline personality disorder.
Christian writes using the boxing metaphor as a tool to figure out which of two risk factors is most important for health - body fat or passive smoking, "Big risk factor contest".
Amy Tenderich writes about Feeling Displaced, regarding a whole bunch of adults with Type 1 who were never children with diabetes -- and many who were but are now grown-up -- are yearning for an organization of our own.
An anonymous blogger is writing a Medications For Pain Series: Narcotics and Opiates.
Sid Schwab of Surgeonsblog writes of what cancer looks like.
David E. Williams at MedTripInfo spent last week touring hospitals in Korea and have done a 9-part diary.
Michael Segal speculates on a link between fidgeting and weight loss.
Kenneth F Trofatter at "Fruit of the Womb" wrote about "Late Preterm Birth - Patient and Provider Education Still Needed". The misperception that it is okay to deliver a few weeks early is very pervasive among both patients and providers and continues to result in tragedies and near misses in neonatal outcomes.
Toni Brayer writes of how primary care is being reimbursed less and less in a reimbursement environment tailored towards paying for procedures.
Paul Auerbach writes of what he's personally experienced recently with his retinal detatchment, with its application to wilderness medicine.
Jeremy Joslin, MD wrote at "Medicine for the Outdoors" about a technique for reducing shoulder dislocations.
Bongi writes of times he's operated on lacerated inferior vena cavas.
Terry tells an anecdotal story about the amnestic qualities of Propofol on my husband after his colonoscopy.
Susan Palwick is a volunteer ER chaplain, wrote this post in a response to a recent tragic suicide at a hospital in my area.
Barbara tells A Story About Chronic Back Pain and a Relationship Gone Sour: Kate and Frank, where we like to think that we can rise to the occasion; but when that occasion is chronic pain, some people sink. This is a story about a couple whose relationship turned sour when back pain became too much for them to bear.
Dr. Val brings a short vignette about her personal "mixed feelings" about breast augmentation.
Finally, I'd encourage you all to check out the forums here at MedHelp, where almost 5 million a month find answers they're looking for, from trusted doctors. The docs here are like bloggers in that they're exposing the details behind what goes on in their minds, just as bloggers make more transparent their view into health & medicine.
Next week's host is http://gcgeorge.net/ and I encourage you all to head over there to participate as enthusiastically as you've done here...
Technorati Tags: health, Health2.0, MedHelp, medicine, technology
Category: Infectious Disease
Posted by: enochchoi
8:55 am PAMF lab notifies us that they have a suspected plague lab sample and plans to send to county lab
9:07 am As liason officer I call City of Palo Alto and Stanford Hospital to notify that PAMF Clinic Command Center is activated. City Emergency Operation Center receives our notification. Stanford Hospital receives our notification.
9:14 am 120 patients have shown up at PAMF Main and 45 arrive at Fremont after receiving news that HP pavilion has been quarantined due to exposure to plague. Many calls from patients asking what to do.
9:15 am Police chief Lynne Johnson acitivated Police/City EOC, city council have been called to request meeting for briefing and prophilaxis is in process of being administered to city council members and first responders
9:17 am PR Jill Antonides & Medical Director/Liason Officer Enoch Choi are advised by Infectious Disease Medical Specialist to develop scripts for phone answering based on county health advice, update website, send message via PAMFonline PHR to avert more calls to PAMF.
9:20am Neigborhood PAN activation of city EOC based on evidence in Stockton 6,000 attendees of jazz concert at HP pavillion have been exposed to plague, turn to 90.1FM http://www.cityofpaloalto.org
9:25am Stanford Hospital advises resource of 20,000 doses of antibiotics as prophilaxis treatment for those exposed. PAMF clinic pharmacy has very little stores of doxycycline and ciprofloxacin
9:27 am Create message on Employee Emergency Information Hotline (you have reached PAMF PAD, palomares menlo park, all clinics and hospitals are operating normally) Should not take messages.
9:33 am Stanford Hospital asks PAMF for status update via Ham operator: PAMF updates status : 120 patients at PAMF PAD & 45 patients at PAMF Fremont
9:34 am Erin Salinger, activated Stanford Hospital EOC: Stanford 4 patients in ER, cough in negative pressure room, 3 pt in FP clinic who have called 911 for transport to ER
9:38 am Staff at PAMF PAD/Fremont Internal Medicine want to know what to do if exposed . Staff
9:41 am Phone call to Enoch as Crescent Park Block Coordinator: message to community alert PAN & businesses, medical distribution center is being set up for antibiotic distribution, block coordinators assess neighborhood.
9:43 am Call Stanford for antibiotics availability. 14 pills per course of doxycycline, so based on availability we will treat for 48 hours then ask patient to get more from medical distribution center. 200 N95 masks available @ PAMF, enough for today
9:46 am Stanford EOC calls for update: 900 doses requested from Stanford for PAMF staff.
9:55 am PAMF requests 500 N95 & 1000 surgical masks from Stanford
9:59 am PAMF requests assistance from Sutter Health
10 am Message to PAD Block Coordinators: City setting up medical distribution center & emergency volunteer center
10:02 am Activation of Pandemic Flu respiratory isolation plan, designating PAMF PAD as sick building and redirecting well to Clark bldg and satellite clinics (los altos, RWC, RWS, Fremont, Palomares)
10:05 am Palo Alto Police Homeland Security coordinator Ken Dueker, JD comes to visit
10:15 am preparing for 11am press statement
10:20 am Stanford requests update: PAMF is sending 5 very ill with respiratory, 20 with suspicious cough and non-critical illness
10:22 am Stanford replies that they do not have antibiotics. Given
10:23 am public health message to block coordinators, asked those exposed or those in contact with those who were exposed, to shelter in place. I called Crescent Park volunteers who then contacted other neighbors to tell them this information.
10:25 am Stanford cannot give any masks, asked for age ranges for those PAMF is sending over
10:27 am Stanford PIO: patients should go to the county for antibiotics, Stanford has no resources to share with PAMF
10:31 am City of Palo Alto message to neighborhood coordinators: via Connect CTY: Neighborhood Coordinators survey: # people attended the concert 0:1 2:1-10 3:11+ I replied (2) which indicated 1-10 Crescent Park individuals
10:36 am PAMF updates county OES with our # patients awaiting 911 transport (5 very ill, 20 suspicious cough) and requests aid: 900 doses antibiotics, 500 N95 masks, 1000 surgical masks
10:45 am PAMF EOC standing down for Golden Guardian exercise
11 am Neighborhood coordinator survey request. I pressed 2 since i wasn't sure if the last time was recorded, since the "thank you" after pressing
Debriefing:
Those who could be called to be Incident Commander could benefit more from going through an exercise like today's simulation to experience the need to make choices
Police calls to PAMF failed to reach PAMF except for initial live call from Police Chief Lynne Johnson stating PA EOC activated. We need a bank of phones tied to the same phone line. We need a FM radio. We need a router to allow multiple computers to be on the 1 ethernet plug-in, to monitor the city/county websites that were updated regularly since we didn't get calls.
Stanford has no resources for mutual aid
My learnings:
I can't be the Crescent Park Block Coordinator since I will be needed at PAMF
Sign up for California Health Alert Network
Get more docs signed up for MVDR
Get wireless EVDO internet access so I can be live during a disaster
9:07 am As liason officer I call City of Palo Alto and Stanford Hospital to notify that PAMF Clinic Command Center is activated. City Emergency Operation Center receives our notification. Stanford Hospital receives our notification.
9:14 am 120 patients have shown up at PAMF Main and 45 arrive at Fremont after receiving news that HP pavilion has been quarantined due to exposure to plague. Many calls from patients asking what to do.
9:15 am Police chief Lynne Johnson acitivated Police/City EOC, city council have been called to request meeting for briefing and prophilaxis is in process of being administered to city council members and first responders
9:17 am PR Jill Antonides & Medical Director/Liason Officer Enoch Choi are advised by Infectious Disease Medical Specialist to develop scripts for phone answering based on county health advice, update website, send message via PAMFonline PHR to avert more calls to PAMF.
9:20am Neigborhood PAN activation of city EOC based on evidence in Stockton 6,000 attendees of jazz concert at HP pavillion have been exposed to plague, turn to 90.1FM http://www.cityofpaloalto.org
9:25am Stanford Hospital advises resource of 20,000 doses of antibiotics as prophilaxis treatment for those exposed. PAMF clinic pharmacy has very little stores of doxycycline and ciprofloxacin
9:27 am Create message on Employee Emergency Information Hotline (you have reached PAMF PAD, palomares menlo park, all clinics and hospitals are operating normally) Should not take messages.
9:33 am Stanford Hospital asks PAMF for status update via Ham operator: PAMF updates status : 120 patients at PAMF PAD & 45 patients at PAMF Fremont
9:34 am Erin Salinger, activated Stanford Hospital EOC: Stanford 4 patients in ER, cough in negative pressure room, 3 pt in FP clinic who have called 911 for transport to ER
9:38 am Staff at PAMF PAD/Fremont Internal Medicine want to know what to do if exposed . Staff
9:41 am Phone call to Enoch as Crescent Park Block Coordinator: message to community alert PAN & businesses, medical distribution center is being set up for antibiotic distribution, block coordinators assess neighborhood.
9:43 am Call Stanford for antibiotics availability. 14 pills per course of doxycycline, so based on availability we will treat for 48 hours then ask patient to get more from medical distribution center. 200 N95 masks available @ PAMF, enough for today
9:46 am Stanford EOC calls for update: 900 doses requested from Stanford for PAMF staff.
9:55 am PAMF requests 500 N95 & 1000 surgical masks from Stanford
9:59 am PAMF requests assistance from Sutter Health
10 am Message to PAD Block Coordinators: City setting up medical distribution center & emergency volunteer center
10:02 am Activation of Pandemic Flu respiratory isolation plan, designating PAMF PAD as sick building and redirecting well to Clark bldg and satellite clinics (los altos, RWC, RWS, Fremont, Palomares)
10:05 am Palo Alto Police Homeland Security coordinator Ken Dueker, JD comes to visit
10:15 am preparing for 11am press statement
10:20 am Stanford requests update: PAMF is sending 5 very ill with respiratory, 20 with suspicious cough and non-critical illness
10:22 am Stanford replies that they do not have antibiotics. Given
10:23 am public health message to block coordinators, asked those exposed or those in contact with those who were exposed, to shelter in place. I called Crescent Park volunteers who then contacted other neighbors to tell them this information.
10:25 am Stanford cannot give any masks, asked for age ranges for those PAMF is sending over
10:27 am Stanford PIO: patients should go to the county for antibiotics, Stanford has no resources to share with PAMF
10:31 am City of Palo Alto message to neighborhood coordinators: via Connect CTY: Neighborhood Coordinators survey: # people attended the concert 0:1 2:1-10 3:11+ I replied (2) which indicated 1-10 Crescent Park individuals
10:36 am PAMF updates county OES with our # patients awaiting 911 transport (5 very ill, 20 suspicious cough) and requests aid: 900 doses antibiotics, 500 N95 masks, 1000 surgical masks
10:45 am PAMF EOC standing down for Golden Guardian exercise
11 am Neighborhood coordinator survey request. I pressed 2 since i wasn't sure if the last time was recorded, since the "thank you" after pressing
Debriefing:
Those who could be called to be Incident Commander could benefit more from going through an exercise like today's simulation to experience the need to make choices
Police calls to PAMF failed to reach PAMF except for initial live call from Police Chief Lynne Johnson stating PA EOC activated. We need a bank of phones tied to the same phone line. We need a FM radio. We need a router to allow multiple computers to be on the 1 ethernet plug-in, to monitor the city/county websites that were updated regularly since we didn't get calls.
Stanford has no resources for mutual aid
My learnings:
I can't be the Crescent Park Block Coordinator since I will be needed at PAMF
Sign up for California Health Alert Network
Get more docs signed up for MVDR
Get wireless EVDO internet access so I can be live during a disaster
Technorati Tags: cough, Disaster, Emergency, health, infection, Palo Alto
11/09: ICERx.org provided prescription information for San Diego Fire Surviors but I didn't know about it
Category: Disaster Preparedness Medical Relief
Posted by: enochchoi
Neil Versel told me today (a week too late) that they activated the same system I used in NOLA relief (katrinahealth.org) but since i didn't know about it, i couldn't write the prescriptions based on the fire survivor's prescription records. There's a story here, how this kind of information is not getting out to faith-based medical providers of disaster care. Neil heard about this since he's in the press.
http://www.surescripts.com/pressrelease-detail.aspx?id=123&ptype=surescripts
FOR IMMEDIATE RELEASE
Media Contact:
Liz Roop
(813) 960-5092, ext. 757
liz@npccs.com
TAMPA, Fla. – (Oct. 24, 2007) – In the wake of the President’s declaration of a state of emergency, ICERx.org (In Case of Emergency Prescription history service) has been activated to provide licensed physicians and pharmacists caring for California wildfire evacuees with private, secure online access to available medication history information for affected individuals.
Armed with this information, health care professionals will be able to effectively assist in the coordination of care and safely renew prescriptions for evacuees, while avoiding harmful prescription errors and potential drug interactions.
Prescription data is available only to U.S.-licensed physicians and pharmacists who have been authenticated and registered on ICERx.org (www.icerx.org). To register, licensed physicians and pharmacists should call 1-888-ICERX-50 (1-888-423-7950) and follow the appropriate prompts.
Through the system, authorized users will be able to securely view the following information:
* A listing of prescription medications taken by the evacuee
* Quantity and day supply
* The pharmacy that filled the prescription
* The provider who wrote the prescription
* Drug information, such as indication and dosage, administration, and interactions
The prescription history information is available from a variety of sources participating in ICERx.org, including community pharmacies, pharmacy benefit managers and state Medicaid programs.
ICERx.org is a public service initiative made possible through the collaborative efforts of the American Medical Association (AMA), Informed Decisions, the National Association of Chain Drug Stores (NACDS), the National Community Pharmacists Association (NCPA), RxHub and SureScripts, as well as government agencies.
Technorati Tags: Disaster, Emergency, health, medication
Category: Disaster Preparedness Medical Relief
Posted by: enochchoi
I'm liveblogging from NASA Ames where they're reviewing the performance of last week's Golden Guardian exercise, where Palo Alto Medical Foundation was a medical partner in the simulation. I was in San Diego caring for fire survivors, and am excited to hear how this disaster exercise went last week. This is the google maps mashup they're using to simulate the event (non-editable in this version but editable in real use)
They're asking for $100 Billion bond to offer emergency loans in a disaster
I think it's funny that I've got this going on iTunes right now:
Don't Panic from the album "Garden State" by Coldplay
They're asking for $100 Billion bond to offer emergency loans in a disaster
I think it's funny that I've got this going on iTunes right now:
Don't Panic from the album "Garden State" by Coldplay
Subject: Disaster Preparedness Event at NASA
You are cordially invited to attend a briefing on the Disaster Preparedness Initiative
Sponsored by Joint Venture: Silicon Valley Network and NASA Ames Research Center
DATE: Friday, November 9, 2007
TIME: 9:00am – 12:00noon
PLACE: NASA Ames Research Center
NASA auditorium, near the large hanger
Plan to arrive about 8:30 at the main gate with a current ID.
Briefing will include:
1.Live demo of COMPIC, a common operating picture with Silicon Valley View data loaded, presented by San Jose Water.
2. NASA announcement and presentation of the Silicon Valley Disaster Response and Recovery Center
3. Updates on Preparedness and related Joint Venture DPI projects and programs.
PLEASE R.S.V.P. to Lisa Bruner, Joint Venture
You are encouraged to pass on this invitation to any interested colleagues.
Joint Venture will provide a map to every R.S.V.P.
Regards,
Rick Ellinger
Joint Venture Silicon Valley Network
Disaster Preparedness Initiative
-----------------------------------------------------------------
Lisa M. Bruner
Executive Assistant
Russell Hancock, President & CEO
Seth Fearey, VP, COO, Smart Valley Director
84 W. Santa Clara Street, Suite 440
San Jose, California 95113
Technorati Tags: Conference, Disaster, Emergency, health, technology
Category: Disaster Preparedness Medical Relief
Posted by: enochchoi
5 days ago, Christ in Action arrived in Ramona, CA and called MPPC (Menlo Park Presbyterian Church) for a medical relief team to join them in assisting the survivors of the fires around San Diego. After a flurry of calls, 9 committed to go: MDs, RNs and support counselors flew down 3 days ago to spend the last 2 days providing medical care in a local church, Mountain View Church. Even though we've returned, we've come back to tell folks that these survivors still need our help. Christ in Action will be there another 2 weeks, feeding folks and helping survivors rebuild. For me, the opportunity to go down was sponsored by my partners at PAMF Palo Alto Medical Clinic and PAMP Palo Alto Menlo Park Parents Club which I sit on the board of.
I was surprised to get the call last week, since I'd checked with the Red Cross and MVDR (county volunteer corp) and they said there was no need. When we arrived, I found that the Red Cross doctor that had been there for the week since they reopened Ramona to let survivors return, was just leaving. The Red Cross told me that the medical needs due to the fire had been met, and the doctor wasn't needed since the rest of the needs were pre-existing to the fire.
Boy were they wrong, we went to the Local Assistance Center (LAC) to offer our services, and in the 1 hour it took the county officer in charge of the whole site to decide to kick us off ("we can't take the liability of you providing care here), we cared for half a dozen survivors. We were unceremoniously escorted off by 5 county officials, and returned to the church which was 2 miles away. What's the big deal with that? Well, many of these folks barely had the resources to get to the LAC, much less get to our church. One survivor gave the story of how they collected bottles for recycling over the last week to save up for the gas to get to the LAC, and couldn't afford to make it up to our church-- sure enough, we didn't see them.
The folks around Ramona weren't like those in nearby affluent San Bernardo which although more severely affected, had many more resources to draw from. More than 350,000 sq acres were burned, with 200 homes consumed in Ramona and nearby. Folks in Ramona told us stories like the following:
The most touching moment the first day for me was praying with someone who shares my wife's name, with a toddler daughter coloring with crayons hiding under the chair her mother sat on. Her house burned down a second time, after having lost her house to the 2004 fires. This woman is amazingly thinking of entering Christian ministry since she realizes that her story is powerful in showing God's provision even through contracting MS, losing sight in 1 eye and 1 ear. She'd left her husband with the kids due to something told to her that was a lie and she was informed it wasn't a lie so she returned to her family.
One mom came in with kids just my own children's ages and genders, and the younger had asthma just like my son. It was all too close for comfort. The mother was disabled, on SSI, complained of the must & mold in the motels they were evacuated to first (which exacerbated her son's asthma). She was overwhelmed with the generosity of the indian reservation who set her up with a mobile home and made it handicap accessible with a ramp, all donated to her. My dad was really marvelous with the boy, gently encouraging him not to sleep with the cat since that'd hurt his asthma. It saddened me to hear how the father refused to stop smoking, making the son's asthma worse. The daughter's vomiting turned out to be a simple case of overindulgence -- eating waaay too much halloween candy. ;)
Many couldn't refill their chronic medications even though their doctors were back in their clinics, they were overwhelmed and not able to get thru the many voicemail messages. Antihypertensives, diabetes medicines, congestive heart meds, blood thinners (coumadin) were some of the critically needed medicines we wrote prescriptions for due to being lost in the fire 12 d ago. Some folks even had excellent PPO insurance but couldn't reach their doctors, but in the frequent instances of those underinsured (out of insurance due to job loss, or Dr in Mexico) we could point them to the Red Cross who would pay for the medicines if they had a doctor to write the prescription. But the Red Cross doc had left. Reminded me of post-Katrina where we could write "shelter eligible" on the prescription and the pharmacy would bill FEMA. The local Ramona pharmacy was providing discounts for survivors.
While at the LAC, just before we arrived there was someone who needed an inhaler and I couldn't find them (they were supposed to have gone over to the taiwanese buddhist relief table). That frustration of not being able to find the survivor, reminded me of a time I accidentally gave one person's advair to another person in Katrina mistakenly, with the unwitting donor saying "well I hope that fellow needed it more than me".
Open wifi in LAC was a blessing... Although Globalcom set up satellite dish for wifi here at the mountain view church, it always happened to be down when i needed it. I think it was God telling me to focus on my teammates and the work, rather than liveblogging it. I managed to liveblog some of it from my phone, but it got too busy to after a while.
Sandy Nissley woke up for cooking every day at 3am, and that 1st night got us into our rooms at 11pm.
The few lacerations we treated, reminded me of sewing up a hand laceration post-Katrina since it was our first patient in both situations, and in Katrina the dust was billowing about, whereas this time we had a very nice sunday school room to operate from.
Children in strollers, and toddlers, heartbreaking, seeing father hug his child toddling into church sooo tightly as if they hadn't seen each other in ages whereas I'd guess that they'd been apart for no more than a few hours since they'd lost their house and had to be travelling together. It made me think, if I lost everything, how much I'd cherish my loved ones more. Some of these folks were told that they'd have 2 hours to evacuate and 30 seconds after getting that call, the flames were starting to consume their homes. Reminded me of the folks who told us that they had no warning other than the Katrina floodwaters bursting thru their front door, and as they ran towards it, getting swept up such that they'd be swimming out of the home thru that very door.
It was such a privilege to be there here to help, and hear their stories. Did I mention that you can go down and help? Christ in Action is taking all volunteers that come.
My Dad told the story of a Chinese provincial governor invited his medical missionary team to come help last month provide "sight to the blind" through the volunteer surgeries of US overseas chinese ophthalmologists. He encouraged us to get political support for our missions in the future.
One local pharmacist was giving refills even with "no refills" since the survivor was out (meds burned with the house) and couldn't reach Dr. since their office wasn't open since there was no clean potable water. How can you let folks back here into Ramona for the last 9 days without clean water until 3 days ago so clinics can't run. Wal-mart donated truckloads of water but that's not sufficient to re-open a clinic.
A dozen navy volunteers came to the Christ in Action site to lend a hand.
A HVAC pensylvania guy drove 43 hours straight (tag teaming with a buddy) to come to volunteer. He showed me how much he really cared for the Nissleys by bringing them Starbucks coffee -- the kinds they liked.
A SF firefighter paramedic and UC davis med school matriculant, who is taking year off to figure out what to do, had just finished a week's duty on the fire line, and saw that CiA was here, so after getting home and clearing it with her family, came right back to volunteer. Ironically, she was feeding us in St. Bernard parish 2 years ago -- we were in that Wal-mart parking lot at the same time. She'd been there with firefighters, and met CiA for the first time there. Who knew we'd meet again 2 years later.
Sandy's husband lost 230 lbs through gastric bypass and needs plastic surgery to remove excess skin, willing to be a demonstration case. I'm advising thailand but if any of you have ideas of american plastic surgeons, Denny's willing to be an educational case if they can have a discount since it's all out of pocket.
A panama canal crane guy I diagnosed with pneumonia, 30 years in panama, fixed CiA's electrical system, now runs forklift here from 3am- 9pm, it's amazing how hard these volunteers work.
My cousin was one of the other physicians, and it was my first time working alongside her... Incredibly energetic, compassionate, and was very helpful with her great spanish. God let her conference on Saturday get cancelled, so she could join us the 2nd day as well.
A local orange county hospitalist was so energetic he reminded me of the energizer bunny.
My strongest memories of my dad here are of doing devotionals in preparation for the sermons he'd be giving on his return. Dad was fabulous with the asthmatic kids, since he was a pediatric allergist. His style of interacting with the kids was so hands-on, hugging, playing with them, it showed me how warm pediatricians are trained to be.
Mauishowers.com gave me the longest showers I've had in recent memory: 10 minute, soooo long! very relaxing.
1st day's meals:
bkfst: biscuits & gravy
lunch: shredded chicken burritos
dinner: spaghetti & meat sauce, wheat baguette
2nd day's meals:
bkfst: chorizo & eggs
lunch: hamburgers
These meals were prepared to feed 1000 or more at a time, it's incredible how huge the scale is. Many firefighters, FEMA, contractors, other volunteer agencies (cityteam, billy graham and samaritans purse) all ate the food we did, as it was probably more palatable than the MREs they'd have otherwise.
The daily devotionals ended with a song, and with so many choir singers in the team, my wanting to continue was cut short by waiting patients...
Our team leader was very self-sacrificial, Melinda delayed her lunch for us and manned the fort.
I realized that giving the same level of care to Medi-Cal (CA state medicaid) patients isn't enough. In Ramona, i did TARs, called in rx, did everything we could for them. In Palo Alto, I give the same level of care to everyone (including medi-cal) but what i do for wealthy PA'ans isn't sufficient to hook indigent patients with the resources they need. They have more needs and not understanding of how to access them since unaware that they're available. It made me want to do more for my own indigent patients when get home.
Doing more overseas is easier without liability concerns, just go and do, no politics. Makes me want to do more international medical missions rather than local US. ones where we'd get thrown out of relief sites.
Local physicians were obviously overwhelmed, usual telephone refills backed up and unable to get approved to get processed, new prescriptions for those lost in fire undone. The situation begs the question for the need for PHR-personal health record access to request to automate this workflow more to decrease work of listening to phone messages and approving these prescriptions which so obviously need to be approved.
If your medication list not in your wallet (or better, a PHR), and if your house, clinic, & pharmacy all burn down, how are you going to know what your medicines are? We helped who we could with approximate prescriptions, but it would have been so much better with the system the government set up after Katrina with KatrinaHealth.org which aggregated the million patient's pharmacy records into one website that I used there to look up their meds and write their prescriptions. No guessing what the blue pill or red pill was, like I was doing here in Ramona.
A paraplegic was driven to LAC for me to examine her in the car (I couldn't write a prescription without examining her in person) so I could order seat riser and shower chair for her, hasn't showered in 12 days since can't transfer without it. Medi-Cal TAR called in, done electronically by pharmacist, and the pharmacist thanked me for coming to help.
CVS pharmacy open 'till 9pm
Walmart $4 prescriptions helped many indigent, but patients still want to be on their old meds. In comparison, meds are much more expensive here than in mexico where many of the residents go to get their meds and bring them back over the border.
We brought our clinic to Calvary Chapel 2 nights ago, where they were hosting a meeting for many survivors (i estimate 100 in the sanctuary) and the pastor asked for a show of hands to see if anyone needed medical care, and noone raised a hand. I can't believe there wasn't one person there who had a medical need. What I heard is that folks in Ramona are very proud and self-suffictient, so they'll probably get the immediate needs in order, and medical ones are ones that can wait.
In reflecting on things we could have improved, since transportation from LAC was such a problem for some, we're looking into whether or not MPPC will allow us to run shuttles via the rental van to bring folks from LAC to the church based clinic. Or else just set up and care for folks out of the minivan on the street just outside the LAC. They could chase us off county property, but I suspect they couldn't shoo us away from parking on public roads.
A senior Red Cross volunteer's attitude was very concerning to me: "these folks were in bad shape before we came, and will be in just as bad shape after we leave" with the implication that the work they were doing was for naught, and not lasting. I'm hoping that attitude was from fatigue from a week of volunteering, since I hope that the pre-existing indigent state of the victims wouldn't prejudice the care provided to them. For me, I realized just how much worse the fire make these already suffering folks suffer more -- if you're already stretched thin, there's nothing like a disaster to push you over the edge.
The need is still there. Folks still need medical care and other relief. If you're available, call & head down and there's plenty to do. Contact
Dr. Denny Nissley
executive director,
Christ in action
Phone 703-368-6286
fax 703-368-6470
www.christinaction.com
It was a great couple days, and I hope to be able to return. I'm meeting with someone from my neighborhood who's driving down a loaned stationwagon full of donations, and my Palo Alto Menlo Park Parents Club is doing a bake sale this coming saturday at the Menlo Park Trader Joe's. Last time they raised over $26,000 for Katrina/Rita survivors, let's see us blow through that record!
I was surprised to get the call last week, since I'd checked with the Red Cross and MVDR (county volunteer corp) and they said there was no need. When we arrived, I found that the Red Cross doctor that had been there for the week since they reopened Ramona to let survivors return, was just leaving. The Red Cross told me that the medical needs due to the fire had been met, and the doctor wasn't needed since the rest of the needs were pre-existing to the fire.
Boy were they wrong, we went to the Local Assistance Center (LAC) to offer our services, and in the 1 hour it took the county officer in charge of the whole site to decide to kick us off ("we can't take the liability of you providing care here), we cared for half a dozen survivors. We were unceremoniously escorted off by 5 county officials, and returned to the church which was 2 miles away. What's the big deal with that? Well, many of these folks barely had the resources to get to the LAC, much less get to our church. One survivor gave the story of how they collected bottles for recycling over the last week to save up for the gas to get to the LAC, and couldn't afford to make it up to our church-- sure enough, we didn't see them.
The folks around Ramona weren't like those in nearby affluent San Bernardo which although more severely affected, had many more resources to draw from. More than 350,000 sq acres were burned, with 200 homes consumed in Ramona and nearby. Folks in Ramona told us stories like the following:
The most touching moment the first day for me was praying with someone who shares my wife's name, with a toddler daughter coloring with crayons hiding under the chair her mother sat on. Her house burned down a second time, after having lost her house to the 2004 fires. This woman is amazingly thinking of entering Christian ministry since she realizes that her story is powerful in showing God's provision even through contracting MS, losing sight in 1 eye and 1 ear. She'd left her husband with the kids due to something told to her that was a lie and she was informed it wasn't a lie so she returned to her family.
One mom came in with kids just my own children's ages and genders, and the younger had asthma just like my son. It was all too close for comfort. The mother was disabled, on SSI, complained of the must & mold in the motels they were evacuated to first (which exacerbated her son's asthma). She was overwhelmed with the generosity of the indian reservation who set her up with a mobile home and made it handicap accessible with a ramp, all donated to her. My dad was really marvelous with the boy, gently encouraging him not to sleep with the cat since that'd hurt his asthma. It saddened me to hear how the father refused to stop smoking, making the son's asthma worse. The daughter's vomiting turned out to be a simple case of overindulgence -- eating waaay too much halloween candy. ;)
Many couldn't refill their chronic medications even though their doctors were back in their clinics, they were overwhelmed and not able to get thru the many voicemail messages. Antihypertensives, diabetes medicines, congestive heart meds, blood thinners (coumadin) were some of the critically needed medicines we wrote prescriptions for due to being lost in the fire 12 d ago. Some folks even had excellent PPO insurance but couldn't reach their doctors, but in the frequent instances of those underinsured (out of insurance due to job loss, or Dr in Mexico) we could point them to the Red Cross who would pay for the medicines if they had a doctor to write the prescription. But the Red Cross doc had left. Reminded me of post-Katrina where we could write "shelter eligible" on the prescription and the pharmacy would bill FEMA. The local Ramona pharmacy was providing discounts for survivors.
While at the LAC, just before we arrived there was someone who needed an inhaler and I couldn't find them (they were supposed to have gone over to the taiwanese buddhist relief table). That frustration of not being able to find the survivor, reminded me of a time I accidentally gave one person's advair to another person in Katrina mistakenly, with the unwitting donor saying "well I hope that fellow needed it more than me".
Open wifi in LAC was a blessing... Although Globalcom set up satellite dish for wifi here at the mountain view church, it always happened to be down when i needed it. I think it was God telling me to focus on my teammates and the work, rather than liveblogging it. I managed to liveblog some of it from my phone, but it got too busy to after a while.
Sandy Nissley woke up for cooking every day at 3am, and that 1st night got us into our rooms at 11pm.
The few lacerations we treated, reminded me of sewing up a hand laceration post-Katrina since it was our first patient in both situations, and in Katrina the dust was billowing about, whereas this time we had a very nice sunday school room to operate from.
Children in strollers, and toddlers, heartbreaking, seeing father hug his child toddling into church sooo tightly as if they hadn't seen each other in ages whereas I'd guess that they'd been apart for no more than a few hours since they'd lost their house and had to be travelling together. It made me think, if I lost everything, how much I'd cherish my loved ones more. Some of these folks were told that they'd have 2 hours to evacuate and 30 seconds after getting that call, the flames were starting to consume their homes. Reminded me of the folks who told us that they had no warning other than the Katrina floodwaters bursting thru their front door, and as they ran towards it, getting swept up such that they'd be swimming out of the home thru that very door.
It was such a privilege to be there here to help, and hear their stories. Did I mention that you can go down and help? Christ in Action is taking all volunteers that come.
My Dad told the story of a Chinese provincial governor invited his medical missionary team to come help last month provide "sight to the blind" through the volunteer surgeries of US overseas chinese ophthalmologists. He encouraged us to get political support for our missions in the future.
One local pharmacist was giving refills even with "no refills" since the survivor was out (meds burned with the house) and couldn't reach Dr. since their office wasn't open since there was no clean potable water. How can you let folks back here into Ramona for the last 9 days without clean water until 3 days ago so clinics can't run. Wal-mart donated truckloads of water but that's not sufficient to re-open a clinic.
A dozen navy volunteers came to the Christ in Action site to lend a hand.
A HVAC pensylvania guy drove 43 hours straight (tag teaming with a buddy) to come to volunteer. He showed me how much he really cared for the Nissleys by bringing them Starbucks coffee -- the kinds they liked.
A SF firefighter paramedic and UC davis med school matriculant, who is taking year off to figure out what to do, had just finished a week's duty on the fire line, and saw that CiA was here, so after getting home and clearing it with her family, came right back to volunteer. Ironically, she was feeding us in St. Bernard parish 2 years ago -- we were in that Wal-mart parking lot at the same time. She'd been there with firefighters, and met CiA for the first time there. Who knew we'd meet again 2 years later.
Sandy's husband lost 230 lbs through gastric bypass and needs plastic surgery to remove excess skin, willing to be a demonstration case. I'm advising thailand but if any of you have ideas of american plastic surgeons, Denny's willing to be an educational case if they can have a discount since it's all out of pocket.
A panama canal crane guy I diagnosed with pneumonia, 30 years in panama, fixed CiA's electrical system, now runs forklift here from 3am- 9pm, it's amazing how hard these volunteers work.
My cousin was one of the other physicians, and it was my first time working alongside her... Incredibly energetic, compassionate, and was very helpful with her great spanish. God let her conference on Saturday get cancelled, so she could join us the 2nd day as well.
A local orange county hospitalist was so energetic he reminded me of the energizer bunny.
My strongest memories of my dad here are of doing devotionals in preparation for the sermons he'd be giving on his return. Dad was fabulous with the asthmatic kids, since he was a pediatric allergist. His style of interacting with the kids was so hands-on, hugging, playing with them, it showed me how warm pediatricians are trained to be.
Mauishowers.com gave me the longest showers I've had in recent memory: 10 minute, soooo long! very relaxing.
1st day's meals:
bkfst: biscuits & gravy
lunch: shredded chicken burritos
dinner: spaghetti & meat sauce, wheat baguette
2nd day's meals:
bkfst: chorizo & eggs
lunch: hamburgers
These meals were prepared to feed 1000 or more at a time, it's incredible how huge the scale is. Many firefighters, FEMA, contractors, other volunteer agencies (cityteam, billy graham and samaritans purse) all ate the food we did, as it was probably more palatable than the MREs they'd have otherwise.
The daily devotionals ended with a song, and with so many choir singers in the team, my wanting to continue was cut short by waiting patients...
Our team leader was very self-sacrificial, Melinda delayed her lunch for us and manned the fort.
I realized that giving the same level of care to Medi-Cal (CA state medicaid) patients isn't enough. In Ramona, i did TARs, called in rx, did everything we could for them. In Palo Alto, I give the same level of care to everyone (including medi-cal) but what i do for wealthy PA'ans isn't sufficient to hook indigent patients with the resources they need. They have more needs and not understanding of how to access them since unaware that they're available. It made me want to do more for my own indigent patients when get home.
Doing more overseas is easier without liability concerns, just go and do, no politics. Makes me want to do more international medical missions rather than local US. ones where we'd get thrown out of relief sites.
Local physicians were obviously overwhelmed, usual telephone refills backed up and unable to get approved to get processed, new prescriptions for those lost in fire undone. The situation begs the question for the need for PHR-personal health record access to request to automate this workflow more to decrease work of listening to phone messages and approving these prescriptions which so obviously need to be approved.
If your medication list not in your wallet (or better, a PHR), and if your house, clinic, & pharmacy all burn down, how are you going to know what your medicines are? We helped who we could with approximate prescriptions, but it would have been so much better with the system the government set up after Katrina with KatrinaHealth.org which aggregated the million patient's pharmacy records into one website that I used there to look up their meds and write their prescriptions. No guessing what the blue pill or red pill was, like I was doing here in Ramona.
A paraplegic was driven to LAC for me to examine her in the car (I couldn't write a prescription without examining her in person) so I could order seat riser and shower chair for her, hasn't showered in 12 days since can't transfer without it. Medi-Cal TAR called in, done electronically by pharmacist, and the pharmacist thanked me for coming to help.
CVS pharmacy open 'till 9pm
Walmart $4 prescriptions helped many indigent, but patients still want to be on their old meds. In comparison, meds are much more expensive here than in mexico where many of the residents go to get their meds and bring them back over the border.
We brought our clinic to Calvary Chapel 2 nights ago, where they were hosting a meeting for many survivors (i estimate 100 in the sanctuary) and the pastor asked for a show of hands to see if anyone needed medical care, and noone raised a hand. I can't believe there wasn't one person there who had a medical need. What I heard is that folks in Ramona are very proud and self-suffictient, so they'll probably get the immediate needs in order, and medical ones are ones that can wait.
In reflecting on things we could have improved, since transportation from LAC was such a problem for some, we're looking into whether or not MPPC will allow us to run shuttles via the rental van to bring folks from LAC to the church based clinic. Or else just set up and care for folks out of the minivan on the street just outside the LAC. They could chase us off county property, but I suspect they couldn't shoo us away from parking on public roads.
A senior Red Cross volunteer's attitude was very concerning to me: "these folks were in bad shape before we came, and will be in just as bad shape after we leave" with the implication that the work they were doing was for naught, and not lasting. I'm hoping that attitude was from fatigue from a week of volunteering, since I hope that the pre-existing indigent state of the victims wouldn't prejudice the care provided to them. For me, I realized just how much worse the fire make these already suffering folks suffer more -- if you're already stretched thin, there's nothing like a disaster to push you over the edge.
The need is still there. Folks still need medical care and other relief. If you're available, call & head down and there's plenty to do. Contact
Dr. Denny Nissley
executive director,
Christ in action
Phone 703-368-6286
fax 703-368-6470
www.christinaction.com
It was a great couple days, and I hope to be able to return. I'm meeting with someone from my neighborhood who's driving down a loaned stationwagon full of donations, and my Palo Alto Menlo Park Parents Club is doing a bake sale this coming saturday at the Menlo Park Trader Joe's. Last time they raised over $26,000 for Katrina/Rita survivors, let's see us blow through that record!
Technorati Tags: Abundant Life Christian Fellowship, Church, Disaster, Emergency, health, Health2.0
Category: Disaster Preparedness Medical Relief
Posted by: enochchoi
I went with Melinda to do relief work after the Katrina floods, and had a very blessed experience. Melinda just called me with an immediate need, for clinics friday and saturday in San Diego for folks returning to their burned homes, to provide basic medical care, flu & tetanus shots, and triage. Thanks to Nicki Carpendale, Henry Thai and Gaurav Aurora, I have coverage for my clinic saturday, & I'm going. My father Dr. Eugene Choi is going as well. He and I received much blessings from working with Melinda, under the umbrella of MPPC and CityTeam after Katrina.
I'll be liveblogging if I can get a connection (at http://www.medhelp.org/user_journals/index/242516 ), but it's such a short trip I'll probably just update everyone here when I get back.
Donations may be made to MPPC (Menlo Park Presbyterian Church) at:
http://tinyurl.com/2c8osv
---------- Forwarded message ----------
From: Melinda Porter
Date: Oct 30, 2007 6:57 PM
Subject: San Diego Fire Medical Team - Urgent Need
To: Enoch Choi
Dear Enoch,
***PLEASE NOTE: I must know if you can participate by 5pm, Wed. 10/31***
I was contacted today by an organization called Christ in Action to see if we could send a medical team to Ramona, CA asap to provide basic medical care for residents, volunteers, and firefighters. This area was hit hard, with over 350,000 acres burned. http://www.ramonasentinel.com/
God is pulling this all together quickly, and the situation is fluid, but here is what we know so far:
Depart Thursday, 11/1 around 7:30pm
Return Saturday, 11/3 around 9:00pm
Most likely San Jose Airport, but maybe SFO
Christ in Action will feed and house us
https://www.christinaction.com/
Will provide basic medical care, possibly tetanus and flu shots
One doctor confirmed, one 90% sure, one nurse practitioner confirmed
You will need to complete a waiver and an application with MPPC (application only if you haven't done a mission trip in last 2 years).
Thank you and God's blessings on each of you!
Melinda
Category: Health blogs
Posted by: enochchoi
ScribeMedia is producing a new WebTV Show called “The Digital Health
Revolution” (DHR):
http://www.scribemedia.org/shows/dhr
This bi-weekly program chronicles how the Internet, computers, mobile
phones and other technologies are impacting health globally.
A major emphasis of DHR will be on how social media (e.g, blogs,
podcasts and social networks) have handed unprecedented power to the
masses. It features in-depth and intimate interviews with the people
who are researching, using and creating the digital technologies that
are reshaping health today.
The show is hosted by Fard Johnmar, founder of healthcare marketing
communications consultancy Envision Solutions, LLC
(www.envisionsolutionsnow.com). Johnmar has been recognized globally
for his social media expertise. He also writes HealthcareVox
(www.healthcarevox.com), which was listed as one of the world’s top
50 English language blogs by edrugsearch.com.
Episode one displayed below features a candid conversation with Marc Monseau of
Johnson & Johnson. Earlier this year his company became one of the
first large health corporations to start an official corporate blog.
In this installment, Marc talks about the evolution of his corporate
blog, JNJ BTW, and how social media is influencing the health industry.
In Episode two seen above, welcome Susannah Fox of the Pew Internet &
American Life Project to the program. Susannah's research has shed
light on how Americans are using and being influenced by the Internet.
In Episode three, an interview with Jim Edwards of BrandWeek NRX.
And thanks to Fard & Peter Cevieri (producer) for asking me to participate, I'm hoping to be on the show shortly...
Technorati Tags: health, Health2.0, medicine, video, technology