Friday Fireside Chat: Dr. Booker, founder, OnPulse

Today, I’m talking to Dr. Corenthian “Corey” Booker.

Corey Booker, not to be confused with the mayor of Newark, is a physician. He received his undergraduate degree in Neurobiology and Physiology at the University of Maryland College, and his medical degree from Creighton University.

Thanks for talking to MedCrunch. What is OnPulse?

OnPulse is a new healthcare product designed to get you, the patient, on the same page as anyone involved in your healthcare. It’s an online environment allowing providers to communicate to one another and their patients. Not only physicians, but staff members –anyone who owns a piece of patient care. With instant online access through the product’s patient profile, connected health teams can view and share relevant information, no matter what EMR they use, or whether they’re at the office, at home or on the road.

Who should use OnPulse?

Any healthcare provider who is currently communicating by email or any specialist trying to manage a large team with email should love OnPulse. Also, any patient who emails their provider should use OnPulse.

How do patients access OnPulse?

It’s web based now (mobile app will be available this summer), so they would log on at http://www.onpulse.com and enter a username and login. Right now, it is by Invitation Only. You can request an invitation at our website. We will release it to more people next month. It can be accessed on iPads and will eventually be available on mobile phones.

What makes OnPulse different from anything else out there?

What makes OnPulse different is we allow the individuals who have an account to own their information. The difference is whenever you stop receiving care somewhere and close an account, you no longer have access to that information. With OnPulse, if you end a relationship with a doctor or provider, you own your information and you can share it with another provider anywhere or anytime you want or the next time you need to access care you can share it with that provider. As a system, multiple providers from different organizations can communicate. It’s based on 4 things: 1. Simplicity. 2. Access. 3. Peace of Mind. 4. On-line teams communicating in one place.

What regulations exist concerning ownership of patient health information?

Multiple state statutes, regulations, and cases govern the ownership of health information and the information contained in medical records. The classic statement of the rule concerning ownership of medical records is that the provider owns the medical records maintained by the provider, subject to the patient’s rights in the information contained in the record.

 
But,under the federal Health Insurance Portability and Accountability Act (HIPAA), every person “has a right of access to inspect and obtain a copy of protected health information.” The Meaningful Use regulations require that outpatient providers give patients clinical summaries within three business days for at least half of all office visits, if requested. Hospitals have to provide an electronic copy of discharge instructions upon request.

 
The stage two meaningful use places a much greater emphasis on patient engagement and set high standards for making data electronically available to patients. Physicians should think about these requirements as they work to implement a new EHR system. The new rules state that a professional must make electronic records available to 50 percent of their patients. Furthermore, 10 percent of a physician’s patients must actually view and download these records.

Should people be concerned about privacy?


As a patient no one knows you have an OnPulse account unless you tell them. Under HIPPA they allow providers to do what they currently do and allow them to invite other providers to the health team. Everyone on the team knows who has access to information. The system is only transparent to those using it.

When did you develop the idea for OnPulse?
I was exposed to communication in our healthcare system during my first summer of medical school. Writing HEDIS measures for the National Committee for Quality Assurance (NCQA), as a Washington Health Policy Fellow intern, taught me that our system was fragmented.

My understanding of communication in healthcare matured in residency when I became responsible for confused patients, busy consultants and returning phone calls to referring doctors for unreceived faxes, but I didn’t do anything about it until my fellowship. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident, you learn to communicate with everyone involved, you manage the communication with among your resident colleagues, consultants, patients and the people who are training you. As a resident I saw, how our means of communication can fail the provider team and the patient. I didn’t know what to do about it at the time.

Within the first six months of my fellowship, I had a patient who looked at me with tears because she had suffered financially, physically and emotionally –she said, ‘I thought you guys were all communicating.’ That was it. I realized that all the faxes, phone calls and emails had failed her and so did our team, despite our best intentions.

Mostly, I learned even more about communicating in healthcare when I became a patient after I ruptured both of my patellar tendons, which connects your knee cap to your lower legs. I realized how difficult it is to navigate healthcare and to have a choice. I also learned how difficult it was for all of the providers to communicate as they are trying to help you reach a certain outcome, especially when they are not in the same organization. For instance I had an orthopedic surgeon and two physical therapist all in different places. This experience really informed how important the asset a patient was to the health team and really improved the system.

How does a patient get started using it?

The patient can either be invited by their provider or they can open their own account. Adding providers is simple. We recommend they that they invite providers that they have an established relationship with, especially an electronic one. If they have multiple providers helping them on a single issue they can suggest to their primary provider to form a health team in OnPulse. Then, you’re able to exchange messages, create a task and share files. Whenever information is requested by you –you receive a text or email alert that something is available to you.

OnPulse spans the communication needs for across sickness, wellness and fitness . For example, some patients even use it to communicate with their fitness trainer, keeping track of a daily routine, and keeping all their health information in one place.

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Are there any costs involved for the patient or the provider?

It is free to an individual patients and individual providers. No fee for individual users either patients or doctors. There are subscription payments as a practice to include your business for independent practices or hospitals.

What are the benefits of using OnPulse?

Medical practices can share vital information with other providers and their mutual patients in an easily accessible, unified place. It gives providers and patients secure access to the entire team of healthcare providers. It gives both peace of mind that what they send is actually received by the right person. It helps streamline communication. And it provides personalized communication with everyone. And it’s free to an individual patient and individual provider to use.

Where do you envision OnPulse in 5 years?

My vision for it is to become the healthcare communication environment of choice for all providers and patients. OnPulse, the new on-line healthcare communication environment for patients and providers.

How did medicine and entrepreneurship meet?

My background is medicine with a consistent thread of entrepreneurship. During my fellowship I completed the masters program in clinical informatics at the Duke University’s Fuqua School of Business to better understand how to apply my ideas to clinical medicine. Prior to this time I dabbled in buying and selling houses, creating an online stationary company for my creative wife Kathy and forming a mobile application development company, but by far (besides my kids) OnPulse is the thing that wakes me up and takes me to bed.

“I believe in better communication in healthcare. That’s why I developed OnPulse, where everyone can easily contribute to the personalized best care for the patient and the patient will own 100 percent of their records, and be able to share them accordingly with their health team of choice.” ~ Corey Booker, MD/founder, OnPulse

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For More Information visit http://www.onpulse.com

 

If you have any questions for Dr. Booker, feel free to ask them below.

13 Hot & Healthy Chinese, Japanese & Thai Choices

1.  Brown rice

2.  Summer rolls

3.  Soybeans steamed in water (rather than oil)

4.  Lobster sauce

5.  Shrimp Lo Mein

6.  Broccoli (stir-fry veggies, light on oil)

7.  Snow peas

8.  Peppers

9.  Steamed veggie dumplings

10.  Soft or Plain tofu (not deep fried)

11.  Request a sprinkling of chopped peanuts, almonds or cashews inside or outside your sushi roll

12.  Request crispy salmon skin in your sushi roll

13.  One Chinese or Thai dish can serve 3 people, so split your dishes

14.  Steamed vegetables

Green tea is a good choice too.

HEALTH.COM “Lean to Go”  

Be sure to check out the full article here:  http://www.health.com/health/gallery/0,,20579042,00.html

 

Enjoy!  Stay healthy. ~Maria

New Migraine Prevention Guidelines

According to the journal, Neurology, some over-the-counter meds, such as ibuprofen & naproxen may prevent migraines.

The guidelines also recommend spikey plant petasites, also known as butterbur, beta-blockers and some prescription drugs for migraine prevention.

Dr. Stewart Tepper treats migraine headaches at Cleveland Clinic.

“This is an easy way for a doctor or care provider to look at what is likely to work and on what basis is that drug likely to work.”

Dr. Tepper recommends you seek out a board certified headache medicine specialist if nothing works.

MIGRAINE SYMPTOMS

By Mayo Clinic staff

Migraine headaches often begin in childhood, adolescence or early adulthood. Migraines may progress through four stages — prodrome, aura, attack and postdrome — though you may not experience all the stages.

Prodrome
One or two days before a migraine, you may notice subtle changes that may signify an oncoming migraine, including:

  • Constipation
  • Depression
  • Diarrhea
  • Food cravings
  • Hyperactivity
  • Irritability
  • Neck stiffness

Aura
Most people experience migraine headaches without aura. Auras are usually visual but can also be sensory, motor or verbal disturbances. Each of these symptoms typically begins gradually, builds up over several minutes, then commonly lasts for 10 to 30 minutes. Examples of aura include:

  • Visual phenomena, such as seeing various shapes, bright spots or flashes of light
  • Vision loss
  • Pins and needles sensations in an arm or leg
  • Speech or language problems

Less commonly, an aura may be associated with aphasia or limb weakness (hemiplegic migraine).

Attack
When untreated, a migraine typically lasts from four to 72 hours, but the frequency with which headaches occur varies from person to person. You may have migraines several times a month or much less frequently. During a migraine, you may experience some of the following symptoms:

  • Pain on one side of your head
  • Pain that has a pulsating, throbbing quality
  • Sensitivity to light, sounds and sometimes smells
  • Nausea and vomiting
  • Blurred vision
  • Diarrhea
  • Lightheadedness, sometimes followed by fainting

Postdrome
The final phase — known as postdrome — occurs after a migraine attack, when you may feel drained and washed out, though some people report feeling mildly euphoric.

When to see a doctor
Migraine headaches are often undiagnosed and untreated. If you regularly experience signs and symptoms of migraine attacks, keep a record of your attacks and how you treated them. Then make an appointment with your doctor to discuss your headaches and decide on a treatment plan.

Even if you have a history of headaches, see your doctor if the pattern changes or your headaches suddenly feel different.

See your doctor immediately or go to the emergency room if you have any of the following signs and symptoms, which may indicate other, more serious medical problems:

  • An abrupt, severe headache like a thunderclap
  • Headache with fever, stiff neck, rash, mental confusion, seizures, double vision, weakness, numbness or trouble speaking
  • Headache after a head injury, especially if the headache gets worse
  • A chronic headache that is worse after coughing, exertion, straining or a sudden movement
  • New headache pain if you’re older than 50

New Guidelines: Treatments Can Help Prevent Migraine

NEW ORLEANS – Research shows that many treatments can help prevent migraine in certain people, yet few people with migraine who are candidates for these preventive treatments actually use them, according to new guidelines issued by the American Academy of Neurology. The guidelines, which were co-developed with the American Headache Society, were announced at the American Academy of Neurology’s 64th Annual Meeting in New Orleans and published in the April 24, 2012, print issue of Neurology®, the medical journal of the American Academy of Neurology.

“Studies show that migraine is underrecognized and undertreated,” said guideline author Stephen D. Silberstein, MD, FACP, FAHS, of Jefferson Headache Center at Thomas Jefferson University in Philadelphia and a Fellow of the American Academy of Neurology.

“About 38 percent of people who suffer from migraine could benefit from preventive treatments, but only less than a third of these people currently use them.”

Unlike acute treatments, which are used to relieve the pain and associated symptoms of a migraine attack when it occurs, preventive treatments usually are taken every day to prevent attacks from occurring as often and to lessen their severity and duration when they do occur.

“Some studies show that migraine attacks can be reduced by more than half with preventive treatments,” Silberstein said.

The guidelines, which reviewed all available evidence on migraine prevention, found that among prescription drugs, the seizure drugs divalproex sodium, sodium valproate and topiramate, along with the beta-blockers metoprolol, propranolol and timolol, are effective for migraine prevention and should be offered to people with migraine to reduce the frequency and severity of attacks. The seizure drug lamotrigine was found to be ineffective in preventing migraine.

The guidelines also reviewed over-the-counter treatments and complementary treatments. The guideline found that the herbal preparation Petasites, also known as butterbur, is effective in preventing migraine. Other treatments that were found to be probably effective are the nonsteroidal anti-inflammatory drugs fenoprofen, ibuprofen, ketoprofen, naproxen and naproxen sodium, subcutaneous histamine and complementary treatments magnesium, MIG-99 (feverfew) and riboflavin.

Silberstein noted that while people do not need a prescription from a physician for these over-the-counter and complementary treatments, they should still see their doctor regularly for follow-up.

“Migraines can get better or worse over time, and people should discuss these changes in the pattern of attacks with their doctors and see whether they need to adjust their dose or even stop their medication or switch to a different medication,” said Silberstein.

“In addition, people need to keep in mind that all drugs, including over-the-counter drugs and complementary treatments, can have side effects or interact with other medications, which should be monitored.”

-more-Learn more about the guideline’s recommendations at http://www.aan.com/guidelines.

The American Academy of Neurology, an association of more than 25,000 neurologists and neuroscience professionals, is dedicated to promoting the highest quality patient-centered neurologic care. A neurologist is a doctor with specialized training in diagnosing, treating and managing disorders of the brain and nervous system such as stroke, Alzheimer’s disease, epilepsy, Parkinson’s disease and multiple sclerosis.

The American Headache Society® (AHS) is a professional society of health care providers dedicated to the study and treatment of headache and face pain. The Society’s objectives are to promote the exchange of information and ideas concerning the causes and treatments of headache and related painful disorders. Educating physicians, health professionals and the public and encouraging scientific research are the primary functions of this organization. AHS activities include an annual scientific meeting,

a comprehensive headache symposium, regional symposia for neurologists and family practice physicians, publication of the journal Headache and sponsorship of the AHS Committee for Headache Education (ACHE). http://www.americanheadachesociety.org

For more information about the American Academy of Neurology, visit http://www.aan.com or find us on Facebook, Twitter, Google+ and YouTube.

__________________________________________________________________________________________

SPECIAL ARTICLE

Evidence-based guideline update: Pharmacologic

treatment for episodic migraine prevention

in adults

Report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society

ABSTRACT

Objective: To provide updated evidence-based recommendations for the preventive treatment of migraine headache. The clinical question addressed was: What pharmacologic therapies are proven effective for migraine prevention?

Methods: The authors analyzed published studies from June 1999 to May 2009 using a struc- tured review process to classify the evidence relative to the efficacy of various medications avail- able in the United States for migraine prevention.

Results and Recommendations: The author panel reviewed 284 abstracts, which ultimately yielded 29 Class I or Class II articles that are reviewed herein. Divalproex sodium, sodium val- proate, topiramate, metoprolol, propranolol, and timolol are effective for migraine prevention and should be offered to patients with migraine to reduce migraine attack frequency and severity (Level A). Frovatriptan is effective for prevention of menstrual migraine (Level A). Lamotrigine is ineffective for migraine prevention (Level A). Neurology® 2012;78:1337–1345

Cool Allergy Relief Tip

Nearly 20% of Americans will suffer from Spring allergies.

Dr. David Lang, an allergist at Cleveland Clinic brings us a “cool” tip.  He says one of the easiest things you can do this time of year to ease allergies is turn up the AC.

“Air conditioning is a major measure that can be effective.  With the air conditioner on and windows closed, you cut down your indoor pollen count by 90 percent or more.  So air conditioning in buildings and cars is key for reducing level of symptoms, medication reliance.”

Dr. Lang recommends seeing an allergist if symptoms don’t respond to natural or over the counter remedies, and interfere with daily functioning.  Right now, tree and grass pollen are at their peak.  Children and pets can be affected too.

Symptoms of Grass Allergies:

Irritated Nose, Throat and Eyes

  • People who suffer from grass allergies may suffer from watering eyes, sneezing and congestion, post-nasal drip, sore throats and dry, constant coughing. A grass allergy can cause a full range of breathing problems, from wheezing to triggering a full-blown asthma attack. Allergic conjunctivitis can also occur, which is an inflammation of the membrane that lines the inside of the eyelids. This causes red-rimmed, swollen eyes and sometimes even a crusting of the eyelids. Allergic shiners–which are dark circles under the eyes that are caused by increased blood flow in irritated sinuses–may also occur with a grass allergy.

Skin Irritation

  • Irritated skin, including redness, itching, rashes, bumps and hives can all occur due to a grass allergy. These reactions can occur anywhere on the body, but often show up on the hands and fingers. Some doctors call this reaction “hayfever of the skin.” Treatment with antihistamines is usually the best way to handle this symptom. Reactions can be severe (even anaphylactic) if the allergen comes into direct contact with open skin, such as when a soccer player falls and scrapes her leg on the grassy field.

General Unwellness

  • As with other seasonal allergies, many people who suffer from grass allergies also complain of extreme fatigue, and feeling mentally dull or “out of it.” These people complain of feeling spacey, unable to concentrate and foggy much of the time. Headaches, mood swings and even nausea can result from a grass allergy.

Natural Relief and Prevention

  • There are many ways to prevent reactions and naturally provide relief once symptoms occur. Daily nasal cleansing with either a neti pot or nasal squirt bottle can be an effective way to irrigate the sinuses and flush allergens from the nasal passages. Another preventative measure is to always wear a mask when you mow the grass, and keep grass cut short. Use air conditioners indoors and in cars whenever possible. Instead of drying clothes on the line, where they can pick up allergens, dry clothes in a dryer during grass pollen season. Shower each night before bed to wash off pollen. For a sore throat due to post nasal drip or coughing, try gargling with warm salt water.

Medication

  • There are many different kinds of over-the-counter and prescription medications available for sufferers of grass allergies. Eye drops, nasal sprays, decongestants and antihistamines are the most popular. There are also various prescription medications available that work with the body in different ways to hinder the release of histamines. According to Medicine Online, immunotherapy allergy shots help many patients.

Read more: Symptoms of a Grass Allergy | eHow.com http://www.ehow.com/about_5057895_symptoms-grass-allergy.html#ixzz1sqHCqlyx