Enough Cottonwoods? Electronic Health Records, Senior Joy, Climate Illogic

Some reactions to yesterday's Anchorage Daily News.  Nothing earth shattering here.  Don't have time to right now for that.

1.  How essential are electronic health records for treating patients? 

In an article on loss of FCC funding for rural health care, Anchorage Daily News reporter Annie Zak wrote:

"They rely on that connectivity for electronic health records, essential for treating patients."

I remember going to a focus group on electronic health records eleven years ago.  At that time the hospitals here didn't have EHR and were pushing to get them.  And now you can't treat patients without them?  I wonder what all the doctors who practiced medicine before EHR existed would say about this statement  or what all those doctors around the world who don't have electronic health records do?  Shut up shop because they don't have an essential tool for treating patients?

Yes, electronic health records make it easier and faster to get patient medical histories and to share records when referring patients to other doctors.  BUT they are NOT an essential tool for treating patients.  If they are essential in some settings, it's only because hospitals have now made them the only records kept.  But, if worse comes to worse, the doctor can ask the patient like they used to do.  And they also mean that confidential medical records are now highly vulnerable to hackers.  It's not a question of if they are breached, just when.

2.  Does senior joy make older folks irrelevant to the young?

Charles Wohlforth had a piece on Tom Choate who climbed Denali five years ago at age 78.  The article talks about older folks giving up ambition and competitiveness for happiness.  He then writes,

"But Angell noted that his quality [being happy and not competitive)] has the perverse effect [of] getting old people ignored, as if contentment means you don't matter."

He gives an example of being ignored in conversations with younger men.  Wohlforth muses:

"Interesting, isn't it, our tendency to patronize the old as we do the young? It's as if, like children, their joy disqualifies them, indicating they can't understand the true toughness of life. As if they don't know adulthood's difficult struggle for goals and status." 

This seems to me a giant leap to a questionable conclusion.  Is it the joy that disqualifies them?  Is it even joy he means here, or rather contentment?  I suspect other possible explanations.  One, the contented senior doesn't have the need to push himself into the conversation as much.  Or, if it is about the younger men's regard for the older, it's that he's no longer keeping current in all the details they think are important and/or he doesn't have power in the world that matters to them.  This would be more consistent with Wohlforth's earlier (in the article) note that being ignored is a condition shared by women and that form of snubbing is much more about power than it is about joy.


3.  Climate Illogic  

This was a letter to the editor.  It's short.  So I can give you the whole letter:

Is there climate change? Of course. Earth's climate has always been in a state of change. Alaska was once a sub-tropical area that became an arctic environment.
Puny man cannot stop or slow this change. One volcano eruption can put tons of greenhouse gases into the environment. Carbon dioxide is a major greenhouse gas produced by every animal that breathes air. It is used by plants and is needed by them to grow and the plants turn this CO2 back into oxygen that we animals breathe in order to live.
If you want to really make a difference, plant trees, disconnect the natural gas and electricity to your house, throw away your vehicle keys and walk everywhere.
Charles Brobst
Anchorage    [emphasis added]

There's plenty of evidence that while climate has changed over the billions of years of earth's existence, that the last 200 years or so have seen a much more rapid change than in the past and this change coincides with the beginning of the industrial revolution.

But that's not my point here.  First Mr. Brobst tells us that "Puny man cannot stop or slow this hang"  and then he makes a list of how 'you' can make a difference (which I take to mean slow the change.)  All the things he lists seem to imply - give up our modern life style.

So I'm guessing he really means to say, "If you want to stop climate change, we have to go back to the StoneAge."  This is not the case.  We just need to find alternative energy sources, cut back in consumption that isn't sustainable, an be willing to explore alternatives to how we live - and the Stone Age isn't the only alternative.  The impacts of climate change - if we do nothing - is clearly problematic for our economy.  The impact of actions to stop climate change actually improve our economy.

4.  People really do hate cottonwoods

In another letter to the editor, Patricia Wells laments to poor state of the Anchorage Coastal Trail - cracking asphalt, trash, leaves piled up on the trail, trees blocking views.  And then she says it:

"Believe me, we do not need any more cottonwood trees."

I get her sentiment - particularly now when the sticky cottonwood catkins pile up on our deck and stick to your feet as you walk on them, using you as their way into your house.  I've written a few posts on cottonwoods. (I just looked - there are 30 posts with the label 'cottonwood.'  Here's one that takes an alternative look at these trees.)  Ultimately, they are huge trees - an anomaly this far north - which grow fast (also an anomaly here) and clean the air, anchor the soil, provide habitat for birds and other animals.  But I get it.  Besides the catkins now, the fluffy cotton will start littering Anchorage later in the summer.

Indigenous People's Global Summit - Felipe Iniquez, Mexico

It's late Saturday night already and I have a lot of video and pictures and thoughts about the Summit. Yesterday (Friday) afternoon I went with three of the African delegates on a short Anchorage tour. Their biggest interest was to go to the mountains and see the snow. We picked up my friend Jeremy on the way and went to Glen Alps and walked to Powerline Pass. I'm sorry I don't have any pictures - all my memory cards were full - but they had a great time playing in the snow for the first time. We even had some big fluffy snow flakes come down while they were up there.

On the way up the hill, Jeremy got a call that his Friday night live host couldn't do the show. Jeremy's been pestering me - and I've been pushing him - to do more live shows with interesting people. So I proposed that we had three delegates to the Summit from Africa who would make a great show. We ate dinner when we got back to Jeremy's and he played with wires, the mic, and his computer until he said, "OK, you're on in three minutes." And we talked about the Summit and their issues back home for the next hour plus. Jeremy's wife came home in the middle and I went to explain what was going on and she said, "I know, I've been listening in the car." Add my wife and I know there were at least two people listening to KWMD while we were on. I don't normally see myself as a radio type, but I was really into the topic and mostly what I had to do was ask the three guests questions.

Today I went with five others who had an extra day before heading back from Anchorage. We went to Hope and back with lots of stops on the way. And despite the strong winds along Turnagain Arm, they seemed to all have a good time.

Here's one video from the Summit - of Felipe de Jesus Iniguez Perez of Jalisco, Mexico.





Here's a link to all the Indigenous Peoples Summit posts.

Alaska Electronic Health Record Initiative

The other day I was invited to go to a focus group today. I only knew it had something to do with health. I had never been to a focus group before, so I thought it would be interesting. Plus they offered lunch and $25.
We got a presentation about the Alaska Electronic Health Record Initiative. We learned that this is being promoted by a couple of groups I'd never heard of. Alaska Chart Link and the EHR Alliance are putting together a plan for electronic health care records in the state of Alaska. They had a grant or two as did 34 other states for this. We were told how this was going to improve:

The quality of health care by

• improving timely access to records
• increasing health safety
• decreasing health costs
• increasing access to care
• increasing the health of Alaskans in general
• increasing patient privacy and records

There were nine of us around the table. Mostly over 40, probably 50, though there were several younger folks too. A number of people were involved with health care.

Finally, after about half an hour, we were asked what we thought. Records security was probably the biggest concern. Who would have control? How can you say these are secure? Well, this is inevitable so I'm glad someone is doing it right. These were various reactions.

Then they had us looking at a couple of different logos to get our reactions.

There was a lot more talking to us than I expected. In part they were trying to get the idea across of what Electronic Health Record stuff was about. We did have a pretty lively group and I think everyone spoke up at least once.

No pictures, didn't seem appropriate.

Afterward, I learned that one of the groups was a physician group and I knew (and respect) two of the doctors on the list. Their concern, I was told, was that this was coming inevitably, and the doctors wanted to frame a system that was set up for the benefit of doctors and patients rather than health care institutions and insurance companies. That put a totally different spin on it, which should have been part of the presentation. After all, I do like the convenience of atm machines and being able to get money from anywhere in the world. And I like being able to book my own airline flights and get my boarding pass on my computer. So if electronic health records are coming, it would be better to have doctors and patients having a strong say in how they are structured. But, it's all in the details and you can be sure the large health systems, insurance, and drug companies are going to want to shape this in ways that increase their profits. Michael Moore, are you on top of this one?

Here's a link to a pdf file on this.