A few shoutouts for productivity

These are some very interesting discoveries I've stumbled upon the recent weeks which I think may be useful to you.

Stereomood

http://www.stereomood.com
Stereomood is one of many Internet radio stations, providing free, streamed music. What makes Stereomood different is that you can choose the music channel appropriate for your mood. Thus you can listen to ambient background music for paper-work, inspiring drummy tunes for an energetic hour or just dreamy instrumental music while taking a nap. If you suddenly feel like jumping to the "opposite mood" there is a button for that, for example when returning to work after napping!

The mood tags are collaboratively done by the listeners so they are pretty natural and music rightly tagged most of the time.

Everytime you hear a tune that impresses you more than others you can "favorite it" for playing later. For all music there's a link to buy the tune or whole CD if you like the artist.

Finally, there's a smartphone app for both iPhone and Android.

TalkTyper

http://talktyper.com
Here is a little gem that caught me by surprise as I didn't realise how easy it has become to translate speech to text now a days. Well, TalkTyper, does that exactly and it does it amazingly well. As you talk to the microphone sentences are converted to text almost instantly and collected in a mini-notepad.

You can select input language and all major languages are provided for and I expect the list to grow quickly as the web is in the background using a Google based speech to speech server. On a technical level, it is a built in Chrome feature (version 11 and above) being decorated with additional tools.

An excellent productivity tool worth knowing about!

Online XPS to PDF converter

http://xps2pdf.co.uk
Internet Explorer is notoriously stubborn, refusing to implement features users need. Printing a document to PDF file is one such feature, whereas Chrome allows you to just select "Save as PDF" as target printer. Explorer has a similiar feature but uses a Microsoft only technology called XPS instead of PDF. And most institutions force us to use Explorer. Thus, an online XPS to PDF converting tool was very much welcomed in my productivity link/tool collection.

Pixlr

http://pixlr.com
This is the web-application of the century and should be topmost in this list but I've mentioned it already a few times. It's the one web-app I use almost everyday and is indespinsible while working with images or photos. It has all of Photoshop's most used features, it's free, it can sync your images with Google Drive or Picasa... its' totally amazing. If you haven't used it, you should now!

Finally,  a few IT tips

I love keyboard shortcuts as they make computer life so much easier - these are the latest I've discovered and definitely worth sharing!

Middle-mouse-clicking a link in your web-browser (Chrome and Firefox at least) will open it in a new tab. Also, middle-clicking an open tab closes it. So lovely!

While doing a Google search, you can anytime start writing again if you want to change your search - just start typing. No need to move mouse pointer to input field!

Impatient while scanning a Youtube video? There's a button for changing playback speed, you can play up to 2x times faster, great for example to quickly browse through a ultrasound tutorial you've seen before. Notice this works only in the HTML5 player, switch here if you're still using Flash.

Five IT skills every doctor should learn and master

IT is not a very sexy term for doctors' ears despite having potential to boost productivity and clinical skills. I find it hard to convince my colleagues that IT could be one the hopes for battling rising costs and burden of modern healthcare. Productivity and effective work is the one most important factor today - a doctor who is highly educated and trained is a much too valuable resource to be seen wasting time fighting a computer or software. Computers are everywhere today and can't be dodged - we are practising desktop medicine instead of bedside medicine. Same goes for the information tsunami, you have to ride it instead of being drowned in it. So I would like to share with you what IT skills I think every doctor should learn and master.

1. Touch type writing

Doctors write text all day long and no single skill is as underestimated as writing fast, many doctors picking the keyboard with one finger for same typing speed as Stephen Hawking.

Words per minute:
Stephen Hawking 15
Slow writer 20
2-3 days training 60
Professional writer 90
Reading aloud 150
World record 216

Training for 2-3 days will give you 300% gain in writing speed - such a number in the NNT world would normally be a breakthrough article in the medical journals!

2. Google Docs (Drive)

I have surrendered to my brain and admit that however I try I will not be able to remember everything. My brain is a powerful processor of information but for organizing and storing it I need an online, easily accessible notebook. Google Docs is exactly that and has become an indispensable tool in daily clinical work. Everything I have learned the years - tips, links, references, quotes, statistics - I have noted in a well organized collection of text and images for easy retrieval bedside or at computer.

Besides being a huge personal notebook, Google Docs will forever change the use you approach information and data - ultimately leading to the 'mobile, paperless office', essential for organizing and accessing your work from wherever you are.

# A vodcast/post about Google Docs in clinical practice is just around the corner - stay tuned! #

3. Social media

Social media for doctors is essentially
1) Great educational material coming online (and free) through blogs and related technologies.
2) Communications platforms (Twitter, Google+ etc) for expanding your contact network - where your colleagues sharing their most valuable learning points and lessons.

Learning to use social media is not about any one technology, like starting Twitter, it is a new lifestyle. It may not be for all but for those who master it I can promise doors opening to a completely new world of e-learning, yielding clinical skills not possible before. Almost every day I find my self implementing something learned from my social media network to patient care. Learning ultrasound would have been impossible for me without social media as it has provided me with teaching material to support me.

4. The web browser

Software installed locally on your hard drive is becoming a thing of the past as data cloud and web-applications take over. The heart of this revolution is the web browser and it is the one software you really have to know inside and out. Tabbed browsing, using the Omnibar (for Chrome), knowing the keyboard shortcuts, working with text (special copy & paste functions), synchronized preferences etc... Mastering these will give you maximum performance while doing your work. And for a busy doctor, productivity is everything!

5. Genuine interest!

Just as the best doctors are those who are genuinely interested and active in their field - the same goes for IT skills. Strive to always become better and have open eyes for improvements, acknowledge that your way of doing things today may not be the most efficient one. Most of your daily tasks involve IT in one way or another and you will find lots of colleagues, especially younger ones who're born with IT at their hands, who are willing to teach you and help you.

An everyday example of IT in use!

Finally, an example from work - a serbian patient who repeatedly came to the ED with mostly non-compliance based problems because he didn't understand his medication list. Problem solved with a simple IT tool, Google Translate!

Being a tech competent physician is key to productivity and efficiency at work, a win:win situation for you and your patients. In the menu above you will find a list of some 10+ posts about technology, IT and social media for doctors. I highly encourage you to check it out!

The ultimate Google+ widget for microblogs - help needed!

Ok this is a medical blog, so what is this discussion doing here you will ask? Well - many visitors here are (medical) bloggers and this is a very practical scenario that needs to be solved. So I'm asking the blogger community for advice, stay tuned and you'll learn some!


So you have a blog and you are using social media also for microblogging - ultrashort comments for quick interactions with your community, "Twitter" style. You want these microblogs to appear on the side bar of your blog - we have all seen the Twitter widget streaming recent tweets. Great for the small stuff that you don't feel like making a lengthy blog about but still want to share with your followers.

Well Twitter is all great but being minimalistic I want everything under the same roof and for me that's Google. I prefer using Google+ for microblogs because of convenience - no extra login or external website to browse to as everything is easily done from the Gmail interface or via my Android. Besides, Twitter is limited to a frustrating few 140 characters and Google+ provides for an excellent platform for professional networking and communications. Twitter is lacking for me.


So a Google+ widget is needed to display these microblogs. That's where the issues start, let me explain.

Google+ is based on Circles which are primarily thought as a layer of privacy. You can post something privately to your colleagues through a "Doctors' only" Circle so that your other friends and family members don't read that. It's tempting to think of Circles as a "channel" or "group" feature - a little like #hashtags are used to categorize posts - but first and foremost it is for privacy. Thus, your Circled posts are not open to the Internet as Public posts are and there is and will never be any RSS stream from these, it would simply defy the function of Circles.

A hack might be to use email forwarding; add an email to the doctors only Circle so that the post is forwarded to some service which adds it to a stream. Sounds good but the details are fuzzy - I will have to work on this. IFTTT might be the platform providing this.

So why not just post Public all the time and stream that to a widget? Well that's no good either - my blog followers would never want to read my non-medical posts. And vice versa - posting Public all the time on Google+ would drown my other followers in topics they are not interested in. Public posts using #hashtags seems like a nice intermediary solution but again I would be overflowing my followers as a whole and there is no way to make a stream from hashtags in Google+.


So I started a Google+ Page as a social-backend for my blog. All posts there are public and thus easily streamed to a widget. There are two major drawbacks with  this way;
1) Notifications on Google+ Pages cannot be forwarded to my personal Google+ or email. I'm too lazy to login to Page just to check for notifications. I like to follow up posts through comments and it's too cumbersome from a seperate Page. Remember a Page is designed to be managed by one or more individuals.
2) How do I choose if I should post a microblog with my personal Google+ profile or the blogs' Page? My  'librarian oriented' brain cannot have my posts disseminated all over in an unsystematic way!


Best of all thus would be if I could post on my personal profile and these then were forwared to the Google+ Page as a public post from where it is then displayed on the gadget. Again I'm looking into the email forwarding possibility but it seems to me there are no options currently available.



So a call out to 'bloggers united' - do you have any suggestions?

Trying to grab that text? Use OCR!

Every now and then you will encounter situations where you can't use the copy & paste technique. Indispencible in the hospital to quickly write consultation texts, letters etc. - nothing is more frustrating as when the medical record system (in an hilarious attempt to stop data theft) cripples the copy/paste function.

Other scenarious where you might need to quickly get some text in electronic format is that when you get a medical letter from a foreign patient. It has happened to me a several times and once in the middle of the night where the patient had acute dyspnea.

Here is what you need to do to do online OCR, "Optical Character Recognition"

1. Convert the text to image

If the text is on your computer you can use any screen grab app to just capture a screen image while having the text open. A favorite of mine is Lightscreen, a portable app thus allowing you to install on USB drive or within your local folder without administration rights.

Text on paper needs to be scanned of course - easily done in modern offices. Make sure the new image is in high quality, PNG is a lossless (no pixels lost while compressing) format highly recommended.

2. Remove patient identifying information

As we are going to use an online application we need to delete any information that might identify the patient. Not that I distrust the website used, just a good habit "just in case".
Open www.pixlr.com - a free, online Photoshop mimic where you can easily manipulate your new image. Just remember to save it back to PNG format agin.

3. Convert to text

So here's the magic ingredient in the cake; www.onlineocr.net is an online tool which takes an image and converts all text it can find to electronic format. Why this one stands out from the other lots out there is that you can even select which language to use! Now that wasn't so difficult!


And now you can do what you want with your text. If you're translating a medical letter just take it to Google translate.

Signs and syndromes in the emergency department

You remember the ad "you can't beat the feeling"? What they didn't know is that there actually is one thing that does beat the feeling of a fresh Cola can - eliciting a sign you've learned in medical school, glued to your cortex years ago and finally making sense! Just like fresh blood on a CT can't lie about subarachnoid hemorrhage, a positive sign can verify a diagnosis you're having in mind. And that is indeed a feeling of excitement and victory. Even drugged Dr House can't hide his wide nostrils of joy as he's hit the nail on the head.

Therefore I decided to learn more signs and even syndromes I might encounter in my emergency department. And it has already made wonders - recently I learned about Rovsing sign and what do you know - next patient coming in with ambulance was a comatose elderly man having fluctuating, horizontal eye movements caused by uremia, a positive Rovsing sign... HOWZAT!

But that's what wise masters have been telling us all the time, doctors or not - what you go looking for, you will find. It's an universal law - and a Russian proverb!.

So I decided to make a list of signs and syndromes I could expect to encounter in my emergency department. In the spirit of social media I want to share this list with you, in hope that it will also increase your skills of diagnosis and pattern recognition. As most of my notes in Google Docs (now Drive) the list is a dynamic one which I am constantly editing to make better. Please feel free to use the comments for feedback or additions if you have some favorite sign or syndrome that has helped you in the ED.

Signs and syndromes in emergency medicine

To complement this list I also have a special collection in my Picasa web album where I collect medical images representing signs or diagnostic clues in the same manner as a picture says 1000 words.

In case you are interesting in more of these there are even more detailed lists on the Internet although I find many of the entries there not so relevant to the ED;

http://medical-dictionary.thefreedictionary.com/disease
http://medical-dictionary.thefreedictionary.com/syndrome

Finally, credit must be given to some sources I have used extensively to make the list;

• Wikipedia
• Whonamedit.com
• fpnotebook.com
• gpnotebook.com
• and others who I haven’t been able to identify (just old notes from med-school)