Going To Sleep Is Free, But

My take on the rumored iPhone

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Podcasts. Everybody's talking about music, but I'd listen to podcasts (like this Make podcast on biodiesel). Any good medical podcasts out there yet?

IBM To Launch Electronic Medical-Record-Sharing Project

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InformationWeek: IBM To Launch Electronic Medical-Record-Sharing Project > April 27, 2005:

Crossing the Digital Divide...And Continuing the Ascent

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Crossing the digital divide is a phrase often used to describe what sets apart those that have computers with internet access and those that do not. It is as if, once the divide is crossed, that's it. You've arrived. Joined the enlightened hoards in digital nirvana. You've got a Dell, a cable modem, Internet Explorer, and a Yahoo account. You can now start looking for the last page on the internet.

The far greater reward waits for those who consider crossing the Great Divide the first step in a journey, and look for ways to travel more easily and extensively (and safely). To do that, you need to read, learn from others, and explore new things. One such facet to be explored is the Firefox web browser. Once you have that, you'll need this one book: Firefox Hacks: Tips and Tools for Next Generation Web Browsing. Nine chapters. 100 Hacks. Let me give you some examples:

• Find stuff
• Identify and Use Toolbar Icons
• Flush and Clear Absolutely Everything
• Make Firefox go fast
• Play with the preference system
• Installing complementary tools
• Take Firefox with you
• Modify tabbed browsing (by Seth!)
• Govern image and ad display
• Add stuff to your toolbars
• Create your own search plugin

Learn this stuff and your own hospital IT staff will bow to your superior knowledge...and what could be better than making their smug look disappear?

Crossing the Digital Divide...And Continuing the Ascent

• Categories: Technology
• Printer Friendly|#| Trackback

Crossing the digital divide is a phrase often used to describe what sets apart those that have computers with internet access and those that do not. It is as if, once the divide is crossed, that's it. You've arrived. Joined the enlightened hoards in digital nirvana. You've got a Dell, a cable modem, Internet Explorer, and a Yahoo account. You can now start looking for the last page on the internet.

The far greater reward waits for those who consider crossing the Great Divide the first step in a journey, and look for ways to travel more easily and extensively (and safely). To do that, you need to read, learn from others, and explore new things. One such facet to be explored is the Firefox web browser. Once you have that, you'll need this one book: Firefox Hacks: Tips and Tools for Next Generation Web Browsing. Nine chapters. 100 Hacks. Let me give you some examples:

• Find stuff
• Identify and Use Toolbar Icons
• Flush and Clear Absolutely Everything
• Make Firefox go fast
• Play with the preference system
• Installing complementary tools
• Take Firefox with you
• Modify tabbed browsing (by Seth!)
• Govern image and ad display
• Add stuff to your toolbars
• Create your own search plugin

Learn this stuff and your own hospital IT staff will bow to your superior knowledge...and what could be better than making their smug look disappear?

Why I'm Excited About Apple's 'Spotlight' Technology

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Rumor has it that Apple will release its next iteration of MacOS X, code named 'Tiger', in April. One component of it that is not a rumor is its new built-in search engine called Spotlight (tech preview pdf). The list of supported files types includes (but is not limited to):

• Plain text
• RTF
• PDF
• Mail
• Keynote presentations
• Microsoft Office Word documents
• Microsoft Office Excel spreadsheets
• Microsoft PowerPoint presentations
• iChat logs (if logging is enabled)

How might this be useful to a clinician? For years now, I've been dropping files onto my hard drive because they contains information I want to have access to in the future. I have an entire textbook of anesthesiology as html files. Literally hundreds if not thousands of pdf files of articles I've saved from NEJM, Anesthesia & Analgesia, and other journals. Every lecture I've ever given. All the CME I've ever done (if available electronically).

I have tried mightily to keep it all organized. Seth Dillingham actually made some software for me to be able to use a local webserver to organize, index and serve all those files on my local machine. Extended to something we called the Reference Laptop Project, we endeavored to put everything an anesthesia resident could need during their training on a $1,000 20 GB Apple iBook, complete with automatic updating of reference materials via wireless LAN. I've installed Plone and learned some Python to be able to make a system that works for me. But now, finally, coming to OS X, is the core technology that will allow me to do what I want as a feature of the operating system itself, or perhaps even as a custom application.

Underneath it all, there's even an API that lets applications access Spotlight's power. Imagine a new application that imposes a structure on the information you already have or will add! As an example, imagine an outline of relevant topics in anesthesiology. For each topic, the application would use Spotlight to create Smart Folders for, say, information on malignant hyperthermia, and airway management, and peri-operative beta blockade. I have a great deal of information on each of these topics already on my hard drive. Some in the Documents folder, some under Sites. Some exists as HTML files, some as PDF, some as powerpoint. And as I add more information, the Smart 'Chapter' will automatically update. Perhaps the very capable makers of Delicious Library will explore creating 'Delicious Reference' just for me.

The future is here. It's just not evenly distributed yet. --William Gibson

The Hipster PDA

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43 Folders has a wonderful post on a way to capture information on the go which they're calling the Hipster PDA. Now, I have tried to use all manner of PDA to keep track of info on the go at the hospital, starting with the Newton all the way up to my current Treo 610. Which one worked best? It was the system I used as an intern--3X5 index cards held together with a binder clip.

I have improved on it slightly over time, only because, as an anesthesiologist I have less stuff to remind myself about. My 'Palmster PDA' consists of the palm of my left hand on which I can conveniently write down who needs an epidural, which of my colleagues needs lunch or a break, or when I need to re-dose the antibiotic for my current patient.

How To Use An iPod

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I've lectured on a variety of topics. I've been asked to give inservices to OR nurses and anesthesia techs alike. No topic is more frequently requested than how to use an iPod. Honest. iPods are becoming more commonplace in the operating room all the time. I've finally found a nice demo on the web of how to operate an iPod which allows self-paced learning:

'Good guys' show just how easy it is to steal ID

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'Good guys' show just how easy it is to steal ID:

The problem is not Google. The problem is the sites that allowed these documents to be indexed. I wonder how successful we would be finding protected health information?

[Via HIPAA Blog]

Using Passwords? Switch to Pass-phrases, Instead.

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Instead, he recommends pass-phrases:

Citation Classics in Anesthetic Journals

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I was listening to some friends talk about taking a large set of information and making it more useful to the user when I thought about a project I helped with to try to remedy this with regard to the body of published literature in medicine. PubMed is the National Library of Medicine's big online database of medical articles (no, I didn't help with that). Searching for a term on PubMed usually gets lots of results but doesn't necessarily get you any closer to finding that key reference that people consider the classic or definitive paper in the field.

As a teacher in academic anesthesia, I saw residents (note the past tense) had little hope of finding the 'right' paper to read unless I gave it to them. If I said 'read about airway management' they would no doubt find some things about airway management, but probably not the paper on airway management. Unless of course they were able to search a subset of articles in PubMed defined in advance to be especially relevant to their field of study. That's how we conceived of the idea of 'Key References'--make it easy to assemble a list of references for whatever purpose. To make it easy, we used a unique identifier for each article called the PubMed ID Number (PMID). Seth Dillingham then wrote a plugin for Conversant that could take that PMID and go to the PubMed system and (politely) request information about the reference such as title, authors, citation, and even the abstract.

'Citation classics in anesthetic journals' by Baltussen and Kindler is comprised of 'seminal advances in anesthesia' which give 'a historic perspective on the scientific progress of this specialty'. The advantage of having them available online as a compilation lies in the fact that they 1) are searchable and 2) linked to related articles in PubMed (something which even the online version of the original article even does not do).

See for yourself: Citation Classics in Anesthetic Journals

After looking up all 100 PMID's for these articles I wrote to the journal editors and suggested they require authors to include PMID's for references they cite in each article but (apparently) failed to make a convincing enough case. Sort of like in, oh, 1995 when I suggested to the editors of another journal that they could put their articles online using Highwire Press and was told that they had their hands full putting back issues on CD.