In the past, women have had to rely on prevention and treatment information for coronary heart disease that was based on research done on men. With the advancement of technology and medical diagnostic equipment work information has been acquired from research with women in mind.

The American Heart Association has finally outlined measures to help women combat and prevent cardiovascular disease, the first evidence-based information for women.

Coronary heart disease (CHD) can be fatal. Nearly two thirds of women who die suddenly had no previously recognized symptoms. It is thus essential to prevent CHD. AHA figures show that about 500,000 women die of heart disease and strokes each year, killing more than the next seven causes of death combined, including cancer.

In comparisons between the genders, WomenHeart, the National Coalition for Women with Heart Disease, says that women are more likely to die within one year of a heart attack than men. Women are twice as likely as men to die after a bypass. And 35% of female and 18% of male heart attack survivors will have a recurrent heart attack within 6 years.

Medical diagnostics has determined the risk factors for cardiovascular disease in both men and women include high cholesterol, blood pressure, smoking, not exercising, obesity, stress and a family history of heart disease and stroke. Many pharmaceutical companies have drugs that will help with some of these factors. But others, like smoking, not exercising and obesity only you only you and your doctor can resolve.

There are many people in our society that have difficulty breathing. They may have asthma, COPD or even lung cancer. When they had difficulty breathing they might use a prescribed inhaler. Inhalers are hand-held devices used for delivering respiratory medication. Although many different styles of inhalers are available, there are two basic types of inhalers. There are many pharmaceutical companies that provide inhalers.

There are the Metered-dose inhalers that use chemical propellants to expel the medication from the inhaler device. To administer the medication, the patient may either use direct inhalation or squeeze the inhaler’s canister.

There are also the Dry powder inhalers that release the medication via rapid inhalation instead of using chemical propellants. The strength of the inhalation required is stronger than that needed to release the medication of a metered-dose inhaler.

There are also nebulizers which are an inhaler alternative. Because of the coordination and strength needed to use metered-dose inhalers and dry powder inhalers, some people may choose to use a nebulizer instead. Nebulizers convert medication into a fine mist that delivers the medication through a facemask that covers the mouth and nose.

If you are having difficulty using your inhaler, a nebulizer may be what you need. Talk to your doctor about the different types of inhalers available. Discuss any difficulties you may be having and find out if a nebulizer may be a better alternative for you. You should also research this piece medical equipment to determine the cost and which one is best for you.

A sharps container, one of the most important pieces of clinic diagnostic equipment, is a container that is filled with used needles and other sharp medical instruments, such as an IV catheter. There are two main types:

• Single use, which are disposed of with the waste inside.
• Reusable, which are robotically emptied and sterilized before being returned for re-use.

Re-using needles is generally not done, as a single use starts to dull them and renders them unsterile. Clinic office diagnostics have shown that sharing needles is most often the cause of AIDS (HIV) and other blood-borne infections spreading among intravenous drug users.

Needles are dropped into the container without touching the outside of the container. Needles should never be pushed or forced into the container, as damage to the container and/or needlestick injuries may result. It is not recommended that you recapping and de-notch needles.

Proper use of a sharps container includes pick up by or delivery to an approved “red bag” or medical waste treatment site. In addition to this pre-existing safety measure, all U.S. medical and educational staff is federally required to be tested on their knowledge of blood borne pathogens.

The most common sharps on containers are red plastic in the US and yellow plastic elsewhere. They were first developed in 1979 when Frontier Plastics Ltd of South Wales in the UK recognized the need for a designed container for the safe disposal of clinical sharps and developed the original Sharpsafe container which was first marketed in 1980.

During the last ten years, increased worldwide focus on safety and environmental impact has led to several positive government mandates being issued regarding engineered medical device standards and the reduction of clinical waste output from health facilities. This has resulted in a move toward reusable containers with built-in safety devices such as trays and locking devices. An example of this type is the Sharpsmart system, developed by Daniels Sharpsmart in 1986 and now used around the world.

Ever considered how hiring the right office staff can affect your practice’s success?

Ask any physician, you will find a variety of answers. Office staff is crucial to the financial, social and cultural success of your practice.

If only it were as easy as putting an ad in the wanted section of the newspaper. The problem is it is difficult to find just the right person. Instead of finding the staff member that can complete your office, you may end up with a person that is bad for office dynamics and economics.

Once you have reached the decision to hire staff after consulting with your current staff, especially your medical office manager. Now take it one-step further. What will new staff be doing? It is essential to have a job description that is agreed upon by the other office staff as well as yourself.

To create this job description you will need to ask yourself the following questions:

1. What area in the practice needs assistance?
2. What kind of person will be able to help you with this?
3. What qualifications will the candidate need?
4. What kind and how much experience will be needed to perform the tasks you have designated?
5. Where and how do you get what you need?

Getting organized on these issues will help guide your search. If your search is for someone with an area of focused experience, you might advertise on health career boards or ask fellow physicians if they know of anyone. If your searching for general office experience, this would not be necessary. You would be able to cast a wider net and consider newspaper classifieds, job boards and more.

Once you have received applications/resumes you need to review their resume for professionalism as well as to get an idea of their career profile. Review the resume for those items that you deemed most important when considering hiring additional staff. This may not be concrete experience, but rather hints of potential future aptitude and a good work attitude. You may consider prescreening candidates by telephone, as it will speak volumes about their communication ability. Questions during this brief contact can include queries about the candidate’s strengths, their current job, past job performance and their career goals.

For those candidates that you invite to the office for an interview, you should prepare beforehand a list of questions. You should have a variety of questions. It should cover past, present and future work, through open-ended questions and/or scenario-based questions. It might also be a good idea to include the office manager or other members of the staff in the interview will be directly supervising the new employee. This will ensure that the full range of questions is asked that complete a picture of the candidate.

Questions to ask candidates may include the following:

1. Ask about how candidates tackled work problems in the past; ask for concrete examples that demonstrate tenacity, problem-solving ability, a good attitude in tough situations, and more.
2. Ask the applicant how they would deal with a typical situation that you and your staff see everyday, problems with patients, or other scenarios.
3. Ask about conflicts they have had with co-workers or managers in the past. How did they get resolved?
4. What is the applicant’s work ethic? Determine this by asking about times in the past they have stayed late, performed extra work, or other tasks. What is their attitude on this?
5. How does the candidate react when given a task he/she is not sure how to do?
6. Depending on what type of staff position you are interviewing for, ask about applicant’s experience with computer programs, accounting/accounts payable, medical diagnostics, medical procedures or operation of medical diagnostic equipment.
7. Always ask if you can contact the applicant’s previous employers.
8. Ask the applicant if they have any questions? This question may give you an idea of how interested the person is in the position.

What happens now?

When you have finished the interview, you should have a good idea of the candidate’s personality, work experience and ethic, and appropriateness of including him/her in your staff. When the applicant believes they should have a clear idea of what the job requirements are. Be sure to write down your impressions of the candidate, answers that stuck in your mind and any questions either during or immediately after interview that you may think of that you did not ask.

Always follow up with the candidate’s references and former employers. You might also perform a background check. The goal of checking into the candidate’s past is to confirm or test his/her professionalism, work ethic and inter-office dynamics.

Being methodical and logical in your hiring process for new staff to ensure that your practice runs smoothly. It will result in a better caliber of candidates and an increased likelihood for a good match in personnel.

OSHA requires any facility with 10 or more employees to have a written evacuation plan. It makes sense, though, from a risk-management standpoint for smaller practices to have some sort of written fire safety policy. To accomplish this, draw your floor plan on graph paper and note the location of exits and fire extinguishers. Also, note steps to take in the event of a fire call 911, press fire alarm, meet in a specified area, etc. Be sure that your office safety policies state that exit doors are clearly marked and never locked or blocked.

Remember your employees come first. Your medical diagnostic equipment is ensured and will be replaced.

An exit route is a continuous and unobstructed path of exit travel from any point within a workplace to a place of safety. An exit route consists of three parts:

1) Exit access - portion of an exit route that leads to an exit.
2) Exit - portion of an exit route that is generally separated from other areas to provide a protected way of travel to the exit discharge.
3) Exit discharge - part of the exit route that leads directly outside or to a street, walkway, refuge area, public way, or open space with access to the outside.

Exit routes must be kept free of explosive or highly flammable furnishings or other decorations.

Exit routes must be arranged so that employees will not have to travel toward a high hazard area, unless the path of travel is effectively shielded from the high hazard area by suitable partitions or other physical barriers

Exit routes must be free and unobstructed. No materials or medical equipment may be placed, either permanently or temporarily, within the exit route. The exit access must not go through a room that can be locked, such as a bathroom, to reach an exit or exit discharge, nor may it lead into a dead-end corridor. Stairs or a ramp must be provided where the exit route is not substantially

Safeguards designed to protect employees during an emergency, such as sprinkler systems, alarm systems, fire doors, exit lighting, must be in proper working order at all times.

Nowadays more people are living longer with chronic medical conditions such as diabetes and heart disease and other medical conditions. As a result, physicians are performing more routine medical tests in their offices to make things more convenient for their patience and less costly.

One good resource a physician needs is access to products online from the nation’s major pharmaceutical companies and medical diagnostic equipment makers. As well as an online source for physicians’ to purchase tools and office testing equipment. This allows the position to shop online instead of having salesman come into his office and taking his valuable time away from his patience.

A physician usually has several books in his office that he can reference when caring for patients. But if a physician has online access to CPT and ICD-9 codes used by Medicare, Medicaid and commercial insurers it can make his job easier and quicker.

Many major pharmaceutical companies will provide a physician with samples in an effort to sell their product. In contrast, medical diagnostic salesman will bring smaller examples of their equipment for the position to test. But good physicians research information on products from both major pharmaceutical companies as well as producers of medical diagnostic equipment.

Online access to news and information from regulatory agencies also keeps a physician well informed and up to date on any new procedures, drugs or equipment.

Basically, you could say that the best resource a physician would be to have access to the nation’s top online supplier of products from pharmaceutical companies, medical equipment makers and manufacturers of physician office equipment.

Pulse oximetry has become the standard non-invasive method of determining arterial oxygen saturation because of its simple functionality and high clinical value. Pulse oximetry has been on the increase in primary care settings as well. Small, inexpensive pulse oximeter units have changed the way primary care physicians evaluate, manage, and treat patients. It provides the physician with a quantitative assessment and measurement with which to manage patients’ chronic and acute illnesses.

Pulse oximetry procedures are billed under separate current procedural terminology (CPT) codes, and can be used in conjunction with other office and outpatient evaluation and management codes. Office staff can be easily trained to perform pulse oximetry, thereby increasing physician patient time, and office and physician revenue.

Pulse oximetry is a noninvasive measurement of arterial oxygen saturation. It measures oxygen saturation within the patient’s hemoglobin using both red and infrared light. The amplitudes of the light signals are measured and mathematically calculated to give oxygen saturation as a percentage. The medical device industry has created an apparatus standard for pulse oximetry. Pulse oximetry accuracy specifications are +/-2 digits. Although pulse oximetry readings may differ from manufacturer to manufacturer based on their proprietary algorithm, all must meet the industry’s device specifications. This value may be affected by other molecules that bind to the patient’s hemoglobin, like carbon monoxide, which produces a higher measurement of saturated hemoglobin. These high levels produce an inaccurate oxygen saturation reading on the pulse oximeter. Values obtained by pulse oximetry that do not correlate with the patient’s physical findings must be confirmed by arterial blood gas in a laboratory.

This type of medical diagnostic equipment when used on a patient with Chronic Obstructed Pulmonary Disease (COPD) may be of benefit with each primary care office visit. Decreased oxygen saturation readings from the patient’s normal baseline can be an early identifier of infection, medication non-compliance, and disease exacerbation. In conjunction with the patient assessment, the oxygen saturation obtained by pulse oximetry may help avoid hospital admissions.

Primary care physicians treat patients with pneumonia in their office on a routine basis. The pulse oximeter assists the physician in determining the severity of the disease and provides documentation to support hospital admission. Patients with aggressive pneumonias may present with decreased oxygen saturation levels and shortness of breath. Pulse oximetry helps quantify the need for hospital/acute care admission and supports the clinical findings of the physician.

The pulse oximeter can be used by the primary care physician as a screening tool for possible sleep disorders when used in conjunction with a patient history. Some portable pulse oximeters have the ability to record and store readings over a 24-hour period. Patients can be sent home with battery powered oximeters for an overnight recording of oxygen saturation. The patient places the oximetry probe on their finger and turns on the oximeter for an overnight recording at their normal bedtime.

Pulse oximetry can be useful in treating infant and pediatric patients in the primary care setting. Infants with Respiratory Syncytial Virus (RSV) and other respiratory problems can present with increased respiratory rates, retractions and low oxygen saturation levels. Pulse oximetry can be a useful assessment tool in evaluating the severity of the illness, and the need for acute care intervention.

Reimbursement for pulse oximetry in the primary care setting can be billed in addition to normal evaluation and management CPT codes. There are three CPT codes that can be used in the primary care setting for pulse oximetry. All three procedural codes can be billed in conjunction with Evaluation and Management (E&M) codes.

The pulse oximeter can be valuable in a physician’s office for any primary care physician. The clinical information that the pulse oximeter provides can be beneficial for the evaluation and management of different diseases. Pulse oximetry can help justify acute care intervention and placement, and help determine severity of a disease process. At a relatively low cost to the nation, it can be used as a screening tool for sleep disorders. A pulse oximeter is a dependable piece of equipment that needs little maintenance, and can become an indispensable tool for the primary care physician.
Excerpt from article in Physician Office Resource, Issue #3.

A physician has a degree in medicine, not computer science or business management. The good news is that selecting an EMR does not require in-depth technical knowledge. But it does require additional physician office equipment, namely a computer. An EMR can reduce time spent charting, provide more efficient patient visits and help meet regulatory requirements.

Take ownership of your decision because it will impact how you practice medicine. Do not delegate it back to office staff or your local computer guy. Although, staff should play a key role in its selection.

Determine what your requirements are. Do not let the salesman drive your selection process. Only you, the physician, know how you practice medicine. It is critical to get the ideal workflow as well as the interaction with office staff to complete a patient visit. You must determine what you want; just electronic charting or do you want end-to-end solutions that extend all the way to claim management.

This means that you must get the right EMR for your specialty. The narrow focus of a specialty EMR allows it to design its system around the unique needs of a position with in his target market. A large focus EMR will have more resources and a wider reach for a client database.

When integrating your practice management you need to consider how you want your system to support metal billing, patient scheduling and practice management. Are all these functions in one complete package or should the EMR interface with existing solutions? An advantage to integrated clinical and practice management is that an integrated coding and can help you develop a more accurate claims process during the encounter, reduce the need to “downcode” or have the staff scrub the claim later.

It is critical to find a system that makes each encounter easier, not harder. Medicine is complex enough without software making things more difficult so focus on ease of use in your search. The simplest way to evaluate ease-of-use is to sample a demo copy a straightforward system will be especially important when staff turns over and new employees need to be brought up to speed quickly.

What about support and upgrades US? You most likely want we can support and possibly nighttime support, even if only reviewing the records. You must consider how seem to support, is it online, phone, 24/7 and are you prepared to talk to a foreign support staff member. Check the references if they give you. Talked to the doctors who have already purchased an EMR. You also need to as, “Will it continue to meet regulatory requirements and support new standards? Can and will it invest in new development? How strong is the company?”

You must also consider the cost of GM cars. The prices ranging from $1000-$100000 can quickly narrow down the search of the system you want. You also need to consider Internet connections and new technologies. It is possible to access medical records entirely over the web. There are options that lower upfront costs, simplify maintenance and provide ease of use of a web application. Do not forget the technology. In healthcare development language and databases should not drive a software selection process. It should assess underlying technology from a defensive standpoint.

This will definitely add to the physician office equipment inventory increasing the value of your practice. This may not be as expensive as some of your medical diagnostic equipment but it is just as important. It may even allow you access information to some of the pharmaceutical company’s newest drugs via the Internet. Now is the time to get your EMR up and running before the government mandates.