Over the past ten to fifteen years, compact fluorescent bulbs (CFL) have surfaced as a viable alternative to incandescent lighting that we’ve used since Edison first developed the tungsten filament lightbulb. It’s a great means to reduce our carbon footprint and lower our utility bills in the process. In cities like NYC where electricity costs a whopping 13+ cents/kWh with enormous delivery charges, you can reduce your electric bills from lighting by over 50% with CFLs.

I’ve been using CFL’s since college days. The bulb I have in the track light to the left has been with me since senior year of college. It still runs strong, and uses about 13-watts of power to generate luminosity equivalent to a 75-watt incandescent bulb. You’ve probably read some of the shortcomings of CFL’s, which includes flickering, delayed startup, and incompatibility with dimmer switches. While these problems have been mostly remedied with stringent quality control and built-in dimming ballasts, the one gripe I’ve had with CFL’s is that their intensities degrade over time.

My 13-watt CFL bulb is made by GE; I’ve had it for about 6 years. I recently bought a 9-watt NVision CFL bulb to place in my side table lantern. When compared to each other, it is clear that the 9-watt bulb is brighter than the 13-watt bulb. I don’t have a light meter to measure the luminosity of the light, but there is a perceivable difference in intensity.

The question now is whether my new bulb will degrade in quality over time. I guess that I’ll have to wait a few years to find out. In the meantime, I’ve replaced the bulbs in my living room area with CFL’s. They work well in general areas, but not as well for reading light. I’ve stuck with my mini-halogen desk lamp for that.

computing misc, tech

The much-hyped Palm Pre, dubbed the “iPhone killer”, was released last week. Its operating system succeeds the antiquated PalmOS that had only received incremental updates over the last decade. The initial reviews have been generally promising, and Palm’s Me2 device appears to offer a viable alternative to the Iphone and HTC Android phone. While useability and eye candy are critical to Palm Pre’s future, how does the device suit the medical community?

It’s important to realize that Palm has been the de-facto standard for medical software. Windows Mobile devices also offer equivalent software packages, but not nearly in as much breadth or stability. This is the main reason why I’ve stuck with my aging Palm TX.

Skyscape and Epocrates are the two main companies that produce medical software for portable devices. As a physician, I basically only need two applications: a drug formulary and a reference manual for my specialty. For ophthalmology, the reference manual of choice is the Wills Eye Manual.

Overall, the medical software availability for the Palm Pre is disappointing. Epocrates does not have a native WebOS edition available yet; the only means to access the drug formulary is to load a legacy hack. Likewise, none of the Skyscape applications have been ported to the new interface–you have to purchase the legacy emulator.

Given that the bulk of a medical application is reference text, you only need to write a user-friendly frontend to load the data. With the Skyscape applications, only one new frontend is needed for all of its manuals. Coding an intuitive interface is no overnight project, but not having useable software by the time your killer device is released will dispel customers.

I’ve noticed that Skyscape has also implemented a graded pricing scheme for its products. It offers a subscription service which provides free upgrades and phone support for one year. Afterward, it appears that the application stops working until you renew. Alternatively, you can purchase a “standard” package for about $20 more that allows you to use the product indefinitely but without updates. A subscription service makes absolutely no sense to anyone who never calls customer support anyway. While medicine is an evolving field, any new medical breakthroughs will unlikely make it into text within a year. I continue to be skeptical about this pricing scheme.

I assume that both Epocrates and Skyscape will eventually offer a discounted upgrade for early adopters once they release a native Palm WebOS application. In the meantime, I’m going to wait until these applications mature.

computing, medicine medicine, tech

Unless you’ve been hiding in a bubble over the last few years, you’ve probably heard of Electronic Medical Records (EMR), or Electronic Health Records (EHR). Some of you may even have experience working with these systems. Dozens of companies have invested millions into computerizing health records with the notion that digital information will remedy the healthcare system’s multitude of problems. These software frontends have evolved into impressively complex applications, ranging from Visual EMRs to BrainLab’s Digital Lightbox touchscreen interfaces.

One of the concerns with electronic data of any form is security. When the security of health information is involved, we cringe–there is an intangible queasiness to having your health records disseminated to the world. The feeling is worse than having your credit card information stolen. No matter the number of bits we throw into our encryption schemes, health policy pundits will always claim that our data can be hacked.

Well, how secure are paper records? If a file room goes up in flame, that’s the end of it. No backup. No recovery. What about theft? That simply involves old-fashioned robbery. No fancy hacking required. The irony is that paper records ARE secure, because of their inherent flaw that EMRs are designed to eliminate–penmanship.

Physicians have horrible penmanship. There are always exceptions, but the stereotype holds true in most cases. I recently spent 2 weeks at a primary care physician’s office. Making any sense of the chart records was simply impossible to an outsider. Lab results? If they’re not correctly placed under the “LABWORK” tab, good luck finding it. Progress notes? I barely advanced past the date. I was able to interpret a few of the cryptic scribble, like “RRR” (heart exam reveals regular rate and rhythm), but only because I am familiar with the jargon.

Take the image above. To a layperson, the scribble writes, “AFTER…”? To a medical professional, that looks like a medication dosing. Ceftriaxone? Ceftin? Ceftibuten? Who knows. To the skilled medical professional, we can work backwards to guess which medication we usually dose at “1 gram IV”.

Poor penmanship is the security system for paper records. Good luck reading any of the record. In fact, we might not even have a record for our VIPs. The data is all in our heads. Your health information is safe with your doctor. That is, until your doctor becomes senile.

computing, medicine humor, medicine, tech

Ophthalmologists love gadgets, and fortunately for us, there is no shortage of neat toys to collect. Topping my list of equipment to collect was a new digital camera–I had been carrying around a Canon A60, which was arguably Canon’s seventh-ever point-and-shoot digital camera. At six years old my Canon was simply the victim of Moore’s law, which states that computing power doubled approximately 18 months. Given that digital cameras are relatively inexpensive nowadays, I decided to replace my Canon.

What camera is suitable for the medical professional?

If I wanted a quality enthusiast camera, I’d have gone with a DSLR. For about $1000, you can have a hobbyist set, with maybe even two lenses. I don’t need that for everyday use. For the average medical professional (or resident), a point-and-shoot camera needs to meet these three criteria: 1) portability 2) functionality 3) price.

I wanted a point-and-shoot camera that I could easily carry around the hospital. One with manual controls would be nice, but is not necessary. This would be a camera that I could use to photograph clinical pathology in the hospital and to use for recreation. If you’re in the market for a new camera, read on. Read more…

computing hobbies, photos, tech

Dozens of online music streaming options have cropped up over the past few years, and many of them offer well-conceived interfaces. Pandora and Last.fm are two of my favorite players, and I will be reviewing them on this post. Please note: I hold no stake in either of these startups, although I would not mind if I am offered a stake…

Although I am relatively technically oriented, Pandora and Last.fm appeal to me through their intuitive interfaces. When I am in the hospital scrolling labs or churning out discharge summaries in the middle of the night, I do not wish to be burdened with menu options. I only want to fire up my portable firefox browser, start up some music, and get back to work.

Pandora.com requires you to create an account. It will save your channel preferences, and automatically load the next time you visit the site. The interface is clean; there is a volume and a “forward” control. The active song is displayed with album art a-la Coverflow.  The right column always displays a banner advertisement that can be [conveniently] removed with Adblock. If you want artist or album information, you can simply click on the links provided. The genre classification system works well to incorporate music of similar taste to that of your original search. Overall, it’s a great free online radio.

Last.fm offers identical content, although the interface is more distracting.  A description of the band and song is provided on every track, along with a colorful background consistent with last.fm’s color scheme. You do not have to create an account to use the website, which allows for easier access. I think that last.fm’s genre algorithm may be slightly more accurate than Pandora’s, although I may simply have a preference for Last.fm’s licensed artists. I typically use Last.fm at work mainly because I don’t have to log into their website.

A third web player that I frequent is Seeqpod. Unlikely Last.fm or Pandora, Seeqpod doesn’t offer a continuous player that tracks similar types of music you like. Instead, it finds the exact song that you search for, and queues it into the player. Furthermore, it links directly to a website that contains the media file so that you can download it! This is the only music search engine/player that I’ve encountered with download capabilities. However, the service appears to be under renovation at this point. Hopefully it will return in due time.

computing tech