With the recent passing of former U.S. President Ronald Reagan after a long battle with Alzheimer’s disease, his wife Nancy Reagan joined an unusual coalition of Republicans and Democrats, such has Orrin Hatch and Diane Feinstein, in calling for expanded federal funding for human embryonic stem cell research, including research into cloning human embryos for use and destruction in research. The language used was that of cures, with the implication that not using increased tax dollars to pursue this avenue of research would directly and surely result in the deaths of sick patients.

That call was opposed by another bipartisan coalition, including President Bush, who claimed that the limited federal funding for medical research should not include expanding already existing funding for embryonic stem cell research, but that the amount available now is sufficient, and that allows funding to be directed toward other important areas of research, including therapies that utilize stem cells from patients’ own bodies, drug therapies, and other innovative, non-destructive techniques. This debate will continue in the months and years to come, as traditional partisan alliances morph and the demand for all types of publicly funded medical research grows.

Proponents of expanding the current federal funding for embryo research, including human cloning, speak of “therapeutic cloning,” “somatic cell nuclear transfer” (SCNT), and “unfertilized blastocysts.” But for whom is “therapeutic cloning” actually therapeutic? What does the process involve? And is an “unfertilized blastocyst” really anything other than a human clone?All human cloning, as with animal cloning, is done by the process of somatic cell nuclear transfer. This is nothing more than the process by which the nuclear DNA from a normal, adult body cell is taken and injected into an egg cell which has been enucleated (had its nucleus removed). The newly formed zygote (single-celled embryo) is then given a small electrical shock in order to begin the process of cell division, just as any other embryo would undergo. In fact, it is then indistinguishable from any other embryo. There are no genetic or other markers to indicate, “This is a clone.” This cloned embryo is what proponents of cloning research choose to call an “unfertilized blastocyst.” This is really nothing more than semantic dissembling to give people the idea that the cloned human embryo is somehow other than human, something that can simply be created and destroyed at will for any purpose without any moral issue. The term itself is scientifically incorrect, as the cell’s nuclear DNA was originally the result of a fertilization process, and the cloned embryo must grow to become a blastocyst (14-celled embryo), just as all embryos pass through the blastocyst stage.

Once this cloned embryo has grown and divided for approximately 10 days, it can have its stem cells harvested, a process which inherently involves the destruction of the embryo. This is what is known as “therapeutic cloning.” The process required to gain access to these stem cells, however, is anything but therapeutic for those involved. Cloning is a notoriously inefficient process, with hundreds of attempts required to develop a single, healthy clone. For this, hundreds of eggs are needed, and they must be harvested from women’s bodies. In order for a woman to donate her eggs for this kind of research, she must take the dangerous drug Lupron to stimulate her ovaries to mature many eggs at once, then she must undergo surgery to remove the eggs. All of this is done with no medical benefit whatsoever to her. The cloned embryos are created using these eggs, the vast majority of which do not survive, and those that do almost always have significant health problems that are not initially identifiable.

What should be made of the call for the federal funding of human cloning? Its proponents would use dissembling language to dehumanize the clones so that the public is unaware that they are seeking to use taxpayer money to create thousands of human clones solely for the purpose of destruction in research. All people of conscience want to provide cures for those who suffer with debilitating illnesses, but using the bodies of women as egg factories and creating human clones simply to destroy them is not the way to accomplish that end. There are other very promising avenues of research, including research using adult stem cells, that should receive heightened attention and public funding instead.

The Thai government has launched the Thailand Center of Excellence for Life Sciences Pharmacogenomics Project, in collaboration with Oracle, to gather and unify health records electronically.

The project involves the development of a large-scale database of unified electronic health records and is intended to provide safer and more effective medications as well as reduced health care costs.

Pharmacogenomics defines how a person’s genetics affects his or her body’s response to medications. It is the basis for individualized medicine, through which drugs are tailored and applied to cater to a person’s personal genetic makeup.

Pharmacogenomics could be a leap forward for health care. At the clinical trial level, it involves information sharing, investigator and patient management, and terminology translation.

At the health care level, it involves biomedical surveillance, determining clinical pathways for standardized patient care and gathering patient and physician information into a centralized database.

Who says small community hospitals don’t use cutting edge IT, or that age is a negative factor in healthcare professionals willingness o adopt it? Who says increased efficiency through IT leads to lay-offs, or that speech recognition technology is best suited to American-born doctors?

Brooks Memorial Hospital in Dunkirk, N.Y., is smashing misconceptions left and right with its creative and successful use of EXSpeech from Stratford, Conn.-based Dictaphone Corp. The hospital’s journey down the speech recognition road began several years ago, as it was replacing its text product and was offered a promotional opportunity by Dictaphone that would, in part, reduce its initial investment in speech technology.

Brooks Memorial Director of Medical Records Cheryll Rogers leaped at that one. “Brooks Memorial’s administration is very progressive. Our president has talked for years about speech recognition technology, so when a promotional opportunity made it possible to purchase 10 speech licenses, we thought that would be a great introduction to the technology. At the time, we also thought 10 licenses would be plenty.”

When the time came to select a transcription text product, Brooks Memorial Hospital involved their transcriptionists in a month-long process of examining several vendors’ text products before officially signing on with their selection of Dictaphone’s EX-text. It was a short but intense period of hands-on due diligence. In the end, Transcription Supervisor Sandy Congdon says the hospital chose the Dictaphone product primarily for ease of use, but also for the reassurance of their support system. “Doctors dictate 24/7, so transcriptionists need support 24/7, too,” she says. Those promotional-opportunity benefits to add on the speech recognition product also were an incentive.

Then said they unto him, Say now Shibboleth: and he said Sibboleth: for he could not frame to pronounce it right. Then they took him and slew him, at the passes of Jordan: and there fell at that time of the Ephraimites forty and two thousand.

Judges 12:6

In Old Testament times, mispronunciation bore a price. The Gileadites (circa 1143 B.C.) used pronunciation to differentiate their own from the Ephraimites, and the consequences of mispronunciation were severe. Today, mispronunciation, though not a matter of life and death, presents problems when it interferes with communication. In scientific nomenclature, Greek or Latin bionomials of infectious disease microorganisms are often mispronounced, sometimes causing confusion among healthcare professionals (e.g., infectious disease physicians, epidemiologists, and even microbiologists). Unlike horticulturalists, who have masterfully developed a large repertoire of common names for botanical species thereby avoiding the need for and potential mispronunciation of classical Greek and Latin, infectious disease specialists still rely on Greek and Latin bionomials.

How important is a standard pronunciation of bionomials? Language is about communication. Provided the parties in a discussion can understand each other, variations in pronunciation of individual words can be tolerated or disregarded. Everyday modern English is filled with examples of variant pronunciations that cause no communication problems (e.g., either, tomato, laboratory, fertile). These variant pronunciations have many causes. Regional practice is probably the single most important variant, but educational and social backgrounds also play a part, as do personal preferences and even etymologic theories. It would be futile and (some believe) undesirable to impose uniformity by prescribing approved pronunciations when communication is not compromised. Moreover, in all languages, pronunciation changes constantly.

PhatWare Corp. has released an updated version of Medical Pack, a 130,000-word English language medical dictionary intended to be used with CalliGrapher and PenOffice. The two products, used by physicians to record handwritten notes on Windows-based tablet PCs and handhelds during rounds, have built-in natural handwriting recognition software that provides word suggestions based on the physician’s handwritten notes. When combined with its standard English dictionary, Medical Pack draws on 225,000 total words to help physicians and other medical professionals spell-check medical documents in common applications like Pocket Word and Notepad. It also contains medical abbreviations, prescription drugs and medical terminology.

Medical assistants are the fastest growing segment of primary care teams. Remarkably little is known about this emerging workforce. In this report, we present information based on a literature review, analysis of secondary workforce data, and interviews with key experts in the field that aim to highlight the basic aspects of medical assistants and discuss issues that need to be addressed in this rapidly growing occupation in the allied health workforce. Critical policy issues are raised about the future impact of a largely unregulated workforce as well as the potential impact of this field on other allied health professions. J Allied Health 2006; 35:233-237.

MEDICAL ASSISTANTS (MAs) represent a large component of the health care workforce in the United States, with an estimated 376,300 individuals occupying positions in outpatient clinics and private physician offices.1 MAs are integral to outpatient health care because of their presence in large numbers and their role in medical office administration. Despite the steady increase in the number of MAs in recent years, little is known about the pathway of entry into the field, the extent and depth of training, the variety of tasks performed in different practice settings, the rates of turnover, and the reasons for exiting the field. As MAs become an increasingly significant component of the health care team, it will be important to define their skills, experiences, and clinical roles more clearly and to advance their occupational activities and contributions in systematic ways.

This report summarizes current information and knowledge in the field of medical assisting and raises critical policy issues and implications for the workforce. To study some of the trends in the MA workforce, we undertook a literature review of published articles on the role of MAs using the MEDLINE database from 1970 to 2004, interviewed key experts in the field of medical assisting, and reviewed workforce data from a variety of national sources. We identified 18 articles describing the role MAs play in particular practice settings where added benefits to having such assistants were noted.2-19 We examined six issues most relevant to the field of medical assisting: scope of practice, training pathways, certification requirements, accreditation requirements, economic incentives, and regulatory mechanisms. We argue that given the rapid growth of MAs in the health care workforce, the lack of standards and consistency in training and scope of practice as well as the potential need for certification and licensure should be addressed.

Over recent years, medical writing has become an integral activity in drug development through the production of high-quality regulatory documents, thus expediting the approval process. In a similar vein, the importance of statistical considerations in drug development has also been increasingly recognized. In particular, the development of a study-specific statistical analysis plan (SAP) is now perceived as best practice for regulatory (and other) studies and is required in many instances. There is a clear need for medical writers and biostatisticians to work closely together during the course of a project; thus, it is advantageous for the medical writer to make a contribution to the development of the SAP. The aim of this article is to detail the benefits to both medical writers and biostatisticians of the project medical writer reviewing the SAP and to highlight the specific issues that should be addressed during the review process. We recommend that this re-view become a routine activity in all pharmaceutical companies and contract research organizations.

The U.S. Department of Health and Human Services (HHS) has initiated two new steps in building an electronic health care system that will allow patients and their physicians to access their complete medical records as needed, leading to reduced medical errors, improved patient care, and reduced health care costs.

HHS Secretary Tommy Thompson said HHS has signed an agreement with the College of American Pathologists (CAP) to license the college’s standardized medical vocabulary system and make it available without charge throughout the country.

He said this action opens the door to establishing a common medical language as a key element in building a unified electronic medical records system.

HHS also has commissioned the Institute of Medicine to design a standardized model of an electronic health record. The health care standards development organization, known as HL7, has been asked to evaluate the model once it has been designed.

HHS will share the standardized model record at no cost with all components of the U.S. health care system and expects to have a model record ready in 2004. It estimates that the free system will reduce medical errors and reduce health care costs by about $100 billion per year. However, many health care institutions will need to invest in computers and train staff.

Welcome to the lazy days of summer! I guess hat is a saying that doesn’t pertain to dental offices, because I don’t seem to remember any summer lazy days in dentistry. Do you?

Like busy dental office schedules filling so quickly, so go the number of new choices dentists have to make when it comes to light curing units. Once again, it’s that constant change in technology.

New technology has once again arrived in the light curing unit arena. The newest trend in curing lights is LED–light emitting diode. Before we review the LED lights, let’s just take a minute to review our curing light options.

QTH–Quartz-Tungsten-Halogen

Quartz-Tungsten-Halogen lights seem to be the most common light cure source in today’s dental practice. Not only have they been used in the dental industry for many years, they are proven and relatively inexpensive.

Most commonly referred to as halogen lights, they are excellent for curing resins and have become a real workhorse in dentistry. Halogen lights produce a blue light by passing current through tungsten filament in a quartz bulb that contains halogen gas. We could really get into it, but this is not a research paper. The light is reflected and then goes through filters, producing a broad wavelength of light to cure resins. Due to the broad wavelength produced, halogen lights also produce some extra heat, but they always cure everything. Have you ever put the light guide on your fingernail? It gets very hot, fast.

The saying, “If you want something done right, do it yourself,” doesn’t apply when it comes to ensuring clean claims.

One person-even one department-is hard pressed to take on this challenge in today’s environment, where the task of coding and billing claims gets more difficult every quarter, possibly every month. That’s how often payers update the rules that govern coding and compliance.

To keep up with ever-changing regulations, patient financial services departments are reaching out to other departments and experts within the hospital to ensure claims are sent correctly the first time. Today, each functional department along the revenue cycle is sharing in the responsibility for reducing the number of days a claim remains in accounts receivable-a difficult task, to say the least.