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Excellent group of blogs. I loved reading each one.
Thanks for participating, Tanya.
GPs need an incentive to earlier transfer possible patients to the specialist. Otherwise quite a lot of will try the one or other medication on their own – usually not to the benefit of the patient.
Germany created a law called integrated medical care joining together in our case: patient, health insurance, GPs., specialists, clinic, physiotherapy, occupational therapy, pharmacy, and rehab. The GPs are required to take part in a course on rheumatology. They earn extra during the first year doing some routine controls. This contract is running for five years now and everyone is happy, as it is a win: win situation. Patients are transferred earlier and get a a quicker appointment (within 2 weeks). This contract is only done with one insurance company and we ask ourselves, why the others aren’t joining.
So giving an incentive (CME credits and extra pay for extra work) is increasing the rate of patients being quickly sent for early diagnosis.
Lothar
PS. corrections done and I think I forgot to post it.
That is a creative solution that sounds like it’s working for you. Creating incentives to benefit the health of the patient is a good idea.
With over 60 RA stories already posted (http://www.rawarrior.com/onset-of-rheumatoid-arthritis-stories/), seems like a significantly greater number of common themes should emerge than merely the three Kelly listed above (better education about the diseases themselves, finding doctors who listen to their patients, and persistence on the part of patients). While I haven’t read all of the respective stories plus comments (no time), by mining the data therein I wonder if one or more phenotypic aspects critical to the Dx and/or Tx of RA (or autoimmune diseases of this category) might not avail itself? If each respective patient involved in this community had a corresponding Electronic Health Record (EHR/EMR) containing such information, then a relatively simple computer algorithm could mine the data for you, to the possible benefit of all.
Bob, I’ve been calling for that very thing since early posts on this blog. In 2009, there were some discussions with a patient and professor named Andrew on several comments pages after I suggested such a project to him using patient blogs.
I didn’t mean to imply that those are the only common threads in onset of RA. I meant that they are the common threads that would improve rheumatology diagnosis generally. I’d be more than glad to work with rheumatology researchers or other RA investigators with ways to look at common threads in either onset or symptoms that are being overlooked in practice generally. I’ve had some conversations to this effect. I so hope that what has come clear to you, Professor, will occur to some rheumatology professors as well! By the way, my about page and the index page for the onset stories both state that I hope for this evidence to be used in that way.
edit: All of that was before EHR! Now this EHR could truly help to create a true picture of RA if the records were accurate. There are unfortunately great limitations in that with RA. Another topic though.
Kelly,
Yes, I give you credit for knowing WAY more than even many Professors, particularly about RA, though certainly not limited to that. By my comment above, I was hoping to spur action by one or more of your followers to try to speed the process. Even without EHRs and computer algorithms, there’s nothing to stop the RA community as a crowdsourcing group from mining the data already present in this database (your blog). Sure, the data will improve with time (and EHRs), but I suspect there’s already key elements here waiting for somebody to point out. I suspect you already are aware of a few, but chose not to mention them at this point. -Bob
My son has Lyme Disease. I have spent countless hours researching Lyme and I have read again and again how many people who had been dianosed with RA have been treated for thier symptoms for years when the underlying cause was Lyme disease. It is critical to see a top Lyme Disease Doctor (LLMD), others won’t know anything about it. My son is being treated by Dr Zhang and is doing very well. His link is below, he also treats autoimmune diseases.
[Note: link removed. See comment reply.]
also just google Lyme and RA and you will find lots of info
Kathy, I’m removing the link since we’ve received hundreds of comments this morning promoting other sites after we were mentioned on AOL.com. I hope you understand. Ido not have time to examine them all – it will take me all day just to reply to the patients asking questions.