Monday, July 13, 2015

2015 Clinical Guideline Resources

Resources updated to support the 2015 Guidelines discussion for new Family Medicine Residents:


Hypertension2014 Evidence-Based Guideline for the Management of High Blood Pressure in Adults
Additional Resources: 
American Family Physician: POEMsJNC 8 Report on Prevention, Evaluation and Treatment of Hypertension
AAFP: 2014 Hypertension Guideline Stands to Simplify Treatment, Says Expert

Hyperlipidemia2013 ACC/AHA Guideline on the Treatment of Blood Cholesterol to Reduce Atherosclerotic Cardiovascular Risk in Adults
American Heart Association: CV Risk Calculator
AAFP: New Guidelines Propose Significant Shift in Cholesterol Management

Diabetes: American Diabetes Association: Standards of Medical Care in Diabetes—2015
(including the new Abridged Standards for Primary Care Providers)
American Association of Clinical Endocrinologists: AACE Comprehensive Diabetes Management Algorithm 2015
Additional Resources: 
National Diabetes Education Program2012 Diabetes Numbers at a Glance
CDC Diabetes Data & Trends

In addition, there are a number of "apps" that I think can be of use in clinic:

1) Agency for Healthcare Research & Quality: electronic Preventive Service Selector (ePSS)
2) Shots by STFM (Society or Teachers of Family Medicine)
3) American Heart Association/American College of Cardiology  ASCVD Risk Calculators (online)

Friday, October 24, 2014

Links for Computer Applications: AAFP Scientific Assembly 2014

Meaningful Use




         Stage 1

      13 required core objectives

      5 menu objectives (from list of 9)

     Total of 18 objectives

     http://www.healthit.gov/providers-professionals/step-5-achieve-meaningful-use-stage-1  

         Stage 2

      17 core objectives

      3 menu objectives (from list of 6)

      total of 20 objectives

     http://www.healthit.gov/providers-professionals/step-5-achieve-meaningful-use-stage-2  

 

EHR Selection & Implementation

        AAFP Center for Health Information Technology

        AAFP Health-IT Guides

    Selecting & Implementing an HER

     http://www.aafp.org/practice-management/health-it/product.html  

CDS Implementation Guides

        HealthIT.gov

    http://www.healthit.gov/policy-researchers-implementers/cds-implementation   

    How-to guides:

     Start with a Strong Foundation for CDS

     Assemble a CDS Implementation Team

     Plan for Successful CDS Development, Design, and Deployment 

     Roll Out Effective CDS Interventions

     Measure Effects and Refine CDS Interventions

Old Fashioned CDS System

        DiagnosisPro: http://en.diagnosispro.com/

Smartphone Apps

Reference

        All-in-one

    UpToDate: www.uptodate.com  

    ePocrates: www.epocrates.com  

    Medscape Mobile App: http://www.medscape.com/public/mobileapp  

Reference

        Leverage content

    Elsevier: ClinicalKey: www.clinicalkey.com  

    Skyscape: Omnio: www.omnio.com  

Drug Reference

        Lexicomp: www.lexi.com

        Micromedex: http://micromedex.com/mobile  

        Monthly Prescribing Reference:

    www.empr.com/app  

        Physician’s Drug Reference:

    Standalone or Omnio

    http://www.pdr.net/resources/mobilepdr/  

Tools

        PatientKeeper

    Patient lists

    Aggregate patient data

    Order entry

    Charge capture

    http://www.patientkeeper.com/mobile-platform/index.html  

Tools

        ePSS: electronic Preventative Services Selector

    AHRQ: http://epss.ahrq.gov/PDA/index.jsp  

        Shots by STFM:

    http://www.immunizationed.org/Shots-Mobile-App  

        ASCVD Risk Estimator: ACC/AHA

    http://www.cardiosource.org/Science-And-Quality/Practice-Guidelines-and-Quality-Standards/2013-Prevention-Guideline-Tools.aspx  

Tools

        VisualDx:

     Diagnosis search/differential builder

    http://www.visualdx.com/features/mobile-access

        MedCalc:

    http://medcalc.medserver.be/  

        Pregnancy wheel

     Huge range

Patient Health Apps

         Calorie counters

         Activity trackers

         Smoking Cessation:

     Smokefree.gov/apps-quitguide

         Patient Social Media:

     CaringBridge: www.caringbridge.org/  

         Exercise monitors

     Fitbit: www.fitbit.com

     Jawbone: www.jambone.com/up  

     Apple Watch: coming

         Sleep monitors

     Sleepbot: www.mysleepbot.com  

     Sleep Cycle: www.sleepcycle.com  


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Tuesday, April 22, 2014

Journal Club Resources

A good place to find Journal Club resources is the Centre for Evidence Based Medicine at Oxford: http://www.cebm.net/

There you can find a step-by-step introduction to the process of EBM, including tools such as the worksheets to appropriately evaluated each type of article.

If you have any trouble using this site, or finding the correct worksheet, please contact me by email.

Thanks,

Dr. Z

Friday, November 22, 2013

A Funny Thing Happened on the Way to ATP 4 - New Cholesterol Guidelines 2013

In somewhat of a surprise move, the National Hearth, Lung and Blood Institute (NHLBI) has partnered with the American Heart Association and American College of Cardiology (AHA/ACC) in order to get new Guidelines out the door.  One set, focused on Cholesterol, is essentially ATP 4 (Adult Treatment Panel 4) replacing the 12 year old ATP 3.  The links for this guideline can be found below.



Risk Calculator (Excel)

A good commentary on this subject can be found at Dr. Bilizarian's blog on Medscape.

A note, this risk calculator appears to overestimate individual risk between 75% and 150%, leading to suggest greatly increased statin use.  More to follow...

Thursday, September 26, 2013

Resources for Toxic Exposures from Environmental Hazards

Excellent case studies in Environmental Medicine can be found at the CDC Agency for Toxic Substances and Disease Registry (ATSDR):
http://www.atsdr.cdc.gov/csem/csem.html

Abstracts for articles on BPA and Phthalates in Adolescents, along with opposing editorial in August 19, 2013 Pediatrics:
BPA article abstract: Bisphenol A and Chronic Disease Risk Factors in US Children
http://pediatrics.aappublications.org/content/132/3/e637.abstract?sid=7355a77d-5ccc-49d1-a93a-deb9047b002b

Phthalate article abstract: Urinary Phthalates and Increased Insulin Resistance in Adolescents
http://pediatrics.aappublications.org/content/132/3/e646.full

Editorial: Urine Chemical Content May Be a False Measure of Environmental Exposure
http://pediatrics.aappublications.org/content/132/3/e747.full

Wednesday, September 25, 2013

NIH Consensus Development Conference on Diagnosing Gestational DiabetesMellitus

While the 2013 ADA recommendations support the 1 step approach to screening for Gestational Diabetes Mellitus, a subsequent NIH Consensus Conference in March 2013 supports the previous 2 step method.  You can find the statement from this conference at :