A History of The Health Information Exchange in Pennsylvania

There is a very informative video about the development of a health information exchange in Pennsylvania. The video explains how the health information exchange was conceptualised and supported by the development of state law leading to an independent authority with stakeholder representation. I was impressed by the sophisticated networking and collaboration that led to a technological solution to important clinical problems whilst also solving the more subtle challenges.

Appendix A – Other Posts in the Series on Health Information Exchanges

Arizona Statewide Health Information Exchange

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Health Information Exchanges

Health Information Exchanges and Chronic Conditions

HIPPA and Health Information Exchanges

Creating a Health Information Exchange in Arizona

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

 

 

 

There Are Many Mediterranean Diets: An Australian Perspective

fruitbowl2byhotblack

The researchers in this Australian study interviewed 102 people of Mediterranean origin about their diet and also observed their food preparation techniques. The researchers grouped the diets into Western, Eastern, North African and Adriatic groups and detailed the components of the diets. They also cross-checked their findings with a number of diet books from different countries.

What I found particularly interesting was a reference to earlier literature referencing a wide variation in individual components of the diet between countries. For example there was four fold difference in fruit consumption between the highest and lowest consuming groups as well as a four-fold difference in vegetable consumption. The authors also reference differences in life expectancy between the countries.

The results of the present study are summarised in Tables 1 and 2 which identify both the frequency of consumption of the diet as well as the components of the diet. The components of the diet detailed here range from Melokhia and Okra through to Focaccia and preserved Walnut. The researchers identified similar diets in neighbouring countries and increasing differences with geographical separation.

This is a detailed study looking at differences in the Mediterranean diet across the Mediterranean region. There is also a reference to the literature for further reading.

Appendix A – Full Citation

Asia Pac J Clin Nutr. 2001;10(1):2-9. There are many Mediterranean diets. Noah A(1), Truswell AS.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Health Information Exchanges and Chronic Conditions: A Brief Discussion

Two physicians discuss the role of health information exchanges in people with chronic health conditions. Chronic health conditions may result in people seeing multiple teams over a prolonged period of time. Enabling the different teams to have an overview of the investigations may reduce the likelihood of duplication of tests. The two physicians here discuss the benefits. This video features on the CORHIO YouTube channel which is a health information exchange in Colorado. There are a number of other videos featured on this channel.

Appendix A – Other Posts in the Series on Health Information Exchanges

Arizona Statewide Health Information Exchange

The Arkansas Health Information Exchange – SHARE

The California Health Information Exchange – Cal Index

Health Information Exchanges

HIPPA and Health Information Exchanges

Creating a Health Information Exchange in Arizona

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

The New Mediterranean Diet Italian Pyramid

fruitbowl2byhotblack

I’ve been taking a closer look at the Mediterranean Diet in order to better understand the relationship to Dementia. There is a complex theoretical underpinning behind the construct of the Mediterranean Diet.

One aspect to understanding the Mediterranean Diet is a knowledge of dietary components. This was originally set out in terms of a Mediterranean food pyramid. The pyramid illustrates foods that should be consumed more frequently at the bottom of the pyramid whilst less frequently consumed foods are placed at the top of the pyramid.

More recently, INRAN (the Italian National Institute for Research on Food and Nutrion) has developed a modern version of the Mediterranean Diet. This is adapted to the Italian ecosystem and adds lifestyle elements.

This development is well explained in this paper by Vitiello and colleagues. The new pyramid adds conviviality – enjoying food as part of a social experience. Daily physical activity is included as an adjunct. There is also a reference to sustainability by preferentially utilising locally sourced products.

This answers the question of whether the Mediterranean Diet should be considered to be a cultural practice as well as a reductionist approach to simply identifying foods that are consumed. This helps the public to understand how they can adopt the diet.

From the perspective of science on the other hand, we need to be clear on exactly what the Mediterranean Diet means in terms of the research findings. To understand that concept we need to take a closer look at the research tools that have been used to investigate the Mediterranean Diet.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

 

 

 

 

The California Health Information Exchange – Cal Index

The above video shows a summary of the California Health Information Exchange referred to as Cal Index. There is more information here but what I found interesting was that this was developed by a non-profit organisation illustrating the variety of organisations which are making health information exchanges possible.

Appendix A – Other Posts in the Series on Health Information Exchanges

Arizona Statewide Health Information Exchange

The Arkansas Health Information Exchange – SHARE

Health Information Exchanges

HIPPA and Health Information Exchanges

Creating a Health Information Exchange in Arizona

Appendix B – Definition of Health Information Exchange

This is the definition of the Health Information Exchange that I use (Hersh et al, 2015)

Health information exchange (HIE), the electronic sharing of clinical information across the boundaries of health care organizations‘.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.

Is Occupational Sitting Related to the Risk of Death From Coronary Heart Disease? An Answer From 1962

I have been interested in the relationship between Mediterranean Diet and Dementia which has led me to the Seven Countries Study – the first study to characterise the diet and the health benefits. One of the papers linked to the study involved US railroad workers and is freely available here. The research team included Dr Ancel Keys (see citation in Appendix B). Although my main question was about Dementia, this study asked about the health effects of sitting behaviour which I have written about previously in several posts.

As a slight aside, when I was reading through this paper which dates back to 1962 I was intrigued to see a reference to the London transport executive who at that time were undertaking a study on the relationship between physical activity and coronary artery disease in bus drivers and conductors. It was also interesting to see the reference to the use of IBM punch cards by the railworkers, a software program written to analyse the data, as well as the use of ICD-6 (International Classification of Diseases) by the researchers.

The researchers looked at three groups of workers – office workers, signal men and section men. Office workers were characterised as having more sedentary jobs. Signal men were considered intermediate in physical activity and included foremen. Section men were responsible for maintenance of the railroad and were characterised as more physically active.

Section men had more violent deaths than office workers. Office workers on the other hand had more deaths from coronary artery disease than section men and in the age group 60-64 this difference was particularly marked.

ASHD deaths account for 76 per cent of the difference in nonviolent death rates between clerks and section men

where ASHD refers to atherosclerotic heart disease.

Indeed in the age group 60-64 the mortality (non-violent deaths) in the clerks was 19 per 1000 compared to 10 in section men. In other words there was almost a two fold increase in the mortality in the sedentary workers.

The last word about this question can’t be from 1962 but it’s interesting to note that there is more recent work that supports this.

Appendix A – Technical Details

The main hypothesis was that ‘men in sedentary occupations have more coronary heart disease than those in occupations requiring moderate to heavy physical activity’

Age adjusted mortality for ASHD was
(a) Clerks 5.7/1000
(b) Switchmen 3.9/1000
(c) Section men 2.8/1000

In Table 3, the researchers present a 95% confidence interval for the non-violent mortality rates (per 1000). For the 60-64 year age group the values are
(a) Clerks: 19.28 +/- 2.054
(b) Switchmen: 15.59 +/- 1.929
(c) Section men: 9.93 +/- 1.966
The researchers use a Chi-squared test to analyse the difference between the groups and chose a 5% value for significance.

Appendix B – Full Citation

Taylor HL, Klepetar E, Keys A, Parlin W, Blackburn H, Puchner T. Death Rates Among Physically Active and Sedentary Employees of the Railroad Industry. American Journal of Public Health and the Nations Health. 1962;52(10):1697-1707.

Index: There are indices for the TAWOP site here and here

Twitter: You can follow ‘The Amazing World of Psychiatry’ Twitter by clicking on this link.

TAWOP Channel: You can follow the TAWOP Channel on YouTube by clicking on this link.

Responses: If you have any comments, you can leave them below or alternatively e-mail justinmarley17@yahoo.co.uk.

Disclaimer: The comments made here represent the opinions of the author and do not represent the profession or any body/organisation. The comments made here are not meant as a source of medical advice and those seeking medical advice are advised to consult with their own doctor. The author is not responsible for the contents of any external sites that are linked to in this blog.

Conflicts of Interest: *For potential conflicts of interest please see the About section.