Q1W2E3 Information

In this digital age, more and more bulks of information which used to be paper-based, from library catalogues to telephone books, are digitized and stored in a central location for easy access. The idea of EMRs started about 40 years ago.

The main proponents of EMRs cite the following advantages:

(1) The use of EHRs supposedly reduces errors in medical records. There is no doubt that handwritten records are subject to lots of human errors due to misspelling, illegibility, and differing terminologies. With the use of EMRs standardization of patient health records may eventually become acheivable.

(2) Paper records can be easily lost. We have heard how fires, floods and other natural catastrophes destroy physical records of many years, data which are lost forever. Digital records can be stored virtually forever and can be kept long after the physical records are gone. EMRs also help keep records of health information that patients tend to forget with time, i.e. inoculations, previous illnesses and medications.

(3) EMRs make health care cost-efficient by consolidating all data in one place. Previously, paper-based records are located in different places and getting access to all of them takes a lot of time and money. In a systematic review, Kripalani et al. evaluated the communication transfer between primary care physicians and hospital-based physicians and found significant deficits in medical information exchange. The review recommended the use of EMRs to resolve these issues and facilitate the continuity of care before, during and after hospitalization. EMRs translates into better treatment for patients. Take the example of one asthma center’s experience with EMR: “A major benefit associated with EMR implementation was the increase in the number of children who were hospitalized with an asthma exacerbation and received an asthma action plan upon discharge. Prior to the EMR system, [only] 4% received an asthma action plan upon discharge. After implementation of the EMR system, 58% received an asthma action plan upon discharge.”

(4) EMRs can save lives. VeriChip, developed by VeriChip Corporation is the first one of its kind ever approved by the US FDA. It enables rapid identification of at-risk patients and access to their medical history, thereby enabling rapid diagnosis and treatment especially in emergency situations. Classic examples are people with diabetes and/or heart problems who have high risk of collapsing and having attacks. VeriChip is also useful in vehicular accidents and other trauma incidents where the victims aren’t capable of answering questions. In cases of large-scale catastrophes, VeriChip facilitates tracking and identification of victims. According to a coroner in Mississippi, VeriChip helped identify victims during the Hurricane Katrina incident.

Earlier this year, Google Health was launched, an online personalized health records service. Google Health is based on the principle that since it’s the patient’s medical record, the patient should control it, decide what should be in it, and who gets access to it. One of the features of the service includes records from hospitals and pharmacies that are Google Health-enabled or are registered Google Health partners.

The HealthVault is another online health information storage service offered by Microsoft with features similar to Google Health. Keith Toussaint, senior program manager with Microsoft HealthVault recently stated ” leading hospitals like Beth Israel Deaconess Medical Center are actually integrating their systems with both us and Google — because some people like one or the other. It’s a Coke or Pepsi thing.”

What are the disadvantages of EMRs? Not surprisingly, privacy rights advocacy groups are the main opponent of EMRs. Here is what they have to say:

(1) EMRs threaten our privacy. In this day and age when people’s mantra is “I need my privacy”, not many people are comfortable about having their entire medical history recorded and digitized for almost just anybody to see – in other words, incursion into people’s privacy. The confidentiality of doctor – patient relationship is still sacrosanct. Besides, medical data can be used against a person in some cases – be it for a job application, insurance coverage or a college scholarship. Although it is against the law to discriminate against people with illnesses and disabilities, it is a fact of life that the fitter you are, the more competitive you are in the job market. The planned incorporation of genetic data in EMRs further adds to people’s fear of incursion into their private sphere.

(2) EMRs can lead to loss of the human touch in health care. In the process of digitalization, the interpersonal aspect in health care may be lost. In handwritten hospital charts, doctors and other health care practitioners may write what they think and they feel based on their personal observations in their very own words. EMR is simply about ticking off boxes and crossing out things in electronic forms. The doctors are forced to think in categories and can seldom express a personal opinion on an individual case. Because of the lack of flexibility of many electronic reporting systems, cases of misclassification of patients and their conditions have been reported.

(3) EMRs are not that efficient. Despite efforts in digitalization and standardization, EMRs are actually far from being standardized and not as efficient as it is purported to be. It often happens that one clinic’s EMR system is not compatible with that of a general practitioner or another clinic’s system, thus belying the claim of added efficiency. In addition, not all users of EMRs are satisfied with the current state of the art. Although the objective is mainly efficiency and healthcare quality, one study showed that nurses in the Netherlands are not completely satisfied with their EMR implemented in 2006-2007.

(4) EMRs are not safe and secure. Google Health and HealthVault are quick in assuring patients of the safety of their online health accounts. Access to the patient’s account is only possible using log ins and password. In addition, HealthVault assures that “all health information transmitted between HealthVault servers and program providers’ systems is encrypted” and that Microsoft does it best to use the “highest standards of security to safeguard consumer health information from theft, loss, or damage.”

However, there are cases wherein passwords and encryptions do not seem to be adequate as data protection tools. Stories of data hacking, stolen identities and blackmail abound. Even high security databases such as those run by banks and credit institutions are often compromised. This impression was aggravated by the many well-publicized incidences of data loss or breach. A few examples are listed below:

November 26, 2007, Canada. Hackers accessed medical information on HIV and hepatitis from a Canadian health agency computer. – September 22, 2008, UK. The National Health Service (NHS) reported the loss of 4 CDs in the mail containing information on 17,990 employees. – September 30, 2008, US. The company Blue Cross and Blue Shield of Louisiana confirmed breach of personal data, including Social Security numbers, phone numbers and addresses of about 1,700 brokers. The data was accidentally attached to a general email.

In addition, there is criticism over Google Health not being a “covered entity under the Health Insurance Portability and Accountability Act of 1996 and the regulations promulgated thereunder (HIPAA)” under its terms and conditions and is therefore not subject to HIPAA privacy of individually identifiable health information. The HealthVault terms and conditions do not mention HIPAA privacy laws so it is not clear what its status is regarding this issue.

(5) VeriChip is not for humans. It is to be expected that although many of us are amenable to the use of RFID chips in pets, the idea of implanting similar chips in human beings is bound to raise hackles in humans, no matter what the US FDA says. A big opponent of th
e VeriChip and similar chips of its kind is the consumer advocacy group Spychip.com. In a position paper, Spychip and many advocacy and consumer awareness groups see RFID tagging (be it on your person or on the items you buy) as a major threat to privacy and civil liberties. They see the tagging as some kind of “Big Brother” operation. Another group, the No VeriChip Inside Movement, likens VeriChip as “cataloguing” humans similar to the way the Nazis have tattooed numbers on the skin of concentration camp detainees. Popular Hollywood films on privacy incursions (e.g. The Net, Public Enemy No. 1) increased further people’s paranoia about personal data.

Where do we go from here? Without doubt, we have the technology to make EMRs standardized and efficient. Google Health, Microsoft HealthVault and similar online personalized health information accounts are enabling patients to take control of their medical records. The main issues that need to be overcome are data security, protection of privacy and gaining the confidence of the patients. It doesn’t seem evident that the use of RFID and similar tagging chips will become acceptable or popular anytime soon. However, we live in a digital world and we cannot hold back progress indefinitely. With improved technology and data protection tools, let us hope the EMR issue will be resolved soon.

In this article we will talk about information on Rutin.

Rutin is found in many plants such as buckwheat, black tea and apple peels. The nutrient is likely to be an antioxidant, anti-carcinogenic, anti-thrombotic, cyto protective and vaso-protective. The nutrient is classified as a bioflavonoid that is related to quercitin and hesperdin. It helps eliminate high cholesterol, develops more elasticity in the walls of the arteries, promotes greater blood flow, and protects the capillary arteries.

Rutin is very helpful in the absorption of Vitamin C – ascorbic acid. It is very important for the healthy collagen (building block of skin), healthy tendons, and arterial venous walls. Rutin has many benefits for the body.

Rutin could be important in the treatment of chronic venous insufficiency, capillary, fragility, hypertension, atherosclerosis, and osteoarthritis. It also treats hemorrhoids, and may help in the prevention of strokes and high cholesterol. It is helpful in many other health issues as well.

Rutin may also treat colitis, venous edema, may strengthen capillaries, and protects against some toxins. Rutin may have anti-inflammatory and anti-carcinogenic properties. Rutin prevents the oxidation of Vitamin C with positive lipid effects.

Information On Rutin – Varicosities

One of the major benefits of rutin is rutin and its effect on varicosities. Some nutrition experts argue that quercetin and rutin work together in helping capillary fragility and, because of this, may help those people who bruise or bleed easily.

Other quercetin and rutin synergistic activities (including hesperidin) is that these nutrients together, help eliminate cholesterol from the body and increase elasticity of the arterial walls, thus, may allow blood to flow through more easily than before.

Further Information On Rutin
Quercetin and Rutin – The Nutrients that work together

Quercetin and Rutin work together and they help the body make the best of vitamin C (which is naturally available in high amounts in rosehips as well as bioflavonoids).

These two nutrients are also important for the maintenance of collagen, this is what keeps our skin healthy, elastic, and firm. You may not know that the breakdown of collagen is what actually leads to wrinkles and lines on ones skin.

Information on Rutin: Precautions on Rutin

There has been no RDA set for Rutin or its related nutrients).
Woman who are nursing or pregnant or those people with a known medical condition should not use supplements of any kind until first talking with their physician.

We believe the best types of dosages range from around 10mgs to 50mgs. Some people do indeed use up to 600 mgs per day, however, we wouldn’t recommend this.

You should only purchase Rutin supplements from pharmaceutical GMP compliant facilities, such places adhere to the strictest manufacturing standards in the world for nutrition and dietary supplements.

If you do obtain your supplements from such places, you can be sure you are getting the amount of rutin you paid for. Both private and government parties have shown that many nutritional supplements on the health market do not contain the actual ingredients listed, or worse, can harbor harmful contaminants.

The financial capital city of Australia is Sydney City. It is also the capital of the eastern state of New South Wales. Known as a financial hub, Sydney has many attractions to enjoy. With an entertainment schedule to knock your socks off to a journey into the known history of Australia, Sydney offers something for every age.

Sydney has options for every taste and budget. From cheap hotel and travel options to high value holidays. No matter what you plan to do or see in Sydney, a rental car will only enhance your stay. You will have access to all the Sydney attractions with a hire car. It is also easy to find a good deal for a car rental. The city does offer a fast paced atmosphere, but for those visiting, you can take the time to enjoy the many wonderful scenic sites and surroundings. Being a major city, Sydney does provide public transport for residents and visitors, but to really grasp the Sydney feeling, your hire car will give you the freedom to explore when and where you want. The sky is the limit!

To find the best hire car deal for your Sydney experience, access a comparative car rental website. Such sites, allow for you to compare from a number of companies for your Sydney car hire. This way you can view all sizes and price ranges, all at once. You will find that the site will display economy cars to luxury vehicles.

Once you have booked your rental car, you can then map out where you wish to explore. And the list of Sydney sites is endless. From Darling Harbour to the famous Bondi Beach. You can also enjoy the Taronga Zoo and the Sydney Opera House or the Chinese Gardens. With parking available at most attractions, your car hire will give you the ability to experience the attractions at your own pace and not based on bus timetables or train schedules.

Sydney is a multi cultured community and you will therefore find cuisines from all over the world represented there. To give justice to your Sydney stay, drive throughout the inner and outer city streets in your hire car, and you may just find a hidden treasure in one of the cafes or restaurants.

Shopping options in Sydney range from popular weekend markets to upmarket boutiques and fashion stores. If you plan to shop till you drop, ensure you have ample storage space in your rental car. There are also some great opportunities to purchase some Sydney and Australia souvenirs, and if you really want to take away something to remember, a picture outside the Opera House or with the Sydney Harbour Bridge as your backdrop, is popular for tourists.

Of course Sydney is an exciting to place to see, but without a hire car, you may find that you cannot optimise your time spent there. Ensure you select the best rental car that will provide you with the space and comfort required. Also know exactly how much you will be paying for the hire car so you do not get hit with unexpected fees and charges upon arrival.