Whereas in the past, medical records were almost entirely contained in standard ink and paper format, US legislation enacted in 1996 (HIPAA) primarily to protect patient records had the secondary effect of encouraging medical practices to begin implementation of EMR (electronic medical records) software. These programs enable doctors and hospitals to rapidly move information across multiple locations-an office convenience that can also be life-saving, as emergency rooms and physicians in the field have access to accurate, up-to-date electronic medical records for patients who can't speak for themselves.

An unforeseen benefit of the EMR software industry, which emerged as a means to help physicians deal with new federal regulations, has been patient empowerment. Patients are now able to download medical records onto flash drives that go with them wherever they go-giving them more choice in selecting a medical care provider. No longer are patients required to physically move records from one practice to the other when changing doctors; no longer do patients who wish to see a new doctor have to wait on the new practice to acquire their old records. And no longer do practices have to spend time waiting on a patient's old doctor to fax over records.

EMR software has revolutionized virtually every industry attached to medicine. A growing trend in medical and insurance practices is directly related to patient convenience: rather than a hard drive, patients can utilize online medical records. Many offices now host secure websites on which patients can view their records, charts, notes, or test results-even reminders about when to schedule things (like cholesterol tests or immunizations).

Patients love it, because it gives them quick access to things that once required a phone call or office visit. Doctors love it, because a well-informed patient who takes advantage of their physican's EMR practices is easier to provide care for.

At one point or another most of us have relied on the care of a registered nurse to provide the aid and support we need to get our health on track. Not only is the nursing profession the largest segment of the healthcare system, but it also makes one of the largest impacts on it, and thus on the lives of everyone. This makes the fact that the United States is on verge of a critical nursing shortage extremely unsettling. Nurse to patient ratios are dropping, jeopardizing patient care in the process. For now, most hospitals with a staffing need can overcome shortages, but a steady decline continues as more and more people don't even consider the viability of nursing as a career. Without steps to ensure the underlying causes are corrected a future worsening of the nursing shortage, as well as healthcare in general, is guaranteed.

Currently, 30 states are suffering from a shortage of nurses. Nearly ninety percent of long term facilities are insufficiently staffed, and are forced to refuse admissions do to the inability to provide basic care. With 126,000 open nursing positions, a number expected to grow to 1.1 million by 2012, the fate of healthcare in the United States is look grim. But with more new nursing jobs expected to be created than for any other occupation, the time is right to reverse the problem.

To avoid the oncoming shortage disaster, and sustain the change, solutions must be developed in: health care systems, image, policy, and education. But, these changes must be developed and maintained by nurse practitioners, leaders, health care executives, media, and government to effectively solve the problem and divert future disaster.

"He who cures the disease
may be the skillfullest,
but he who prevents it
is the safest."
Thomas Fuller, 1608-1681

Getting Healthy implies that you are not considered healthy at this time but you want to regain your health and vitality. When you google the tem you'll find that getting healthy is an even more ambiguous concept than "staying healthy". The basic question is, where you come from. Apparently excess weight is one of the starting points, so the Harvard University, School for Public Health web site may have some useful advice. Anyway it seems that for Google "getting healthy" means getting off the couch and start exercising. This may be an important step for all those people living a sedentary lifestyle, but that is - of course - only part of the story.

Most people that read this column are recovering from an illness or injury and are interested to regain their health as quickly as possible and they tacitly define health as Vitality and Energy. If you are one of those people, you are in the right place, because drug-centric medicine cannot get you there. Drugs are designed for and can do a good job in making the symptoms vanish, i.e. get rid of the signs of the disease, but the cause may not subside and still be there when the symptoms are gone. If so, it is just a question of time until other, possibly worse symptoms will occur. So this is a good time to analyze what has made you sick in the first place and then develop a program to build up your immunity, as the first step towards regaining your strength.

Unfortunately, few people are aware of the significance of identifying the cause of disease, particularly when it seems to be over. But having no symptoms does not mean it's over and it rarely is. For example, a survivor of chemo-therapy may celebrate victory, but the immune system is now destroyed and the subject is vulnerable to even the weakest attack. It is vital to build up resistance immediately to ward off any attackers, meaning that the lifestyle has to be adjusted to avoid exposure to toxic elements wherever they occur, in food, water, air, environment, personal care and household detergent products.

The incumbent may be simply overtaxed with the task, but Naturopathic Clinics staffed by NMD's, or ND's are specialized to analyze, remedy and coach the person to regain his or her original strength and vitality. Very often we meet people with so called "unexplained symptoms", that is when the doctor sends you home because there is nothing wrong, but you just feel miserable. These conditions are more serious than what meets the eye, a patient implicitly accused of faking a disease, just because drugs-centric medicine fails to diagnose a cause, may suffer from stress, depression and low self-esteem and these conditions do not help in the healing process.

In any case when you feel "not healthy" - don't wait for it to go away, it is a situation to take action in order to avoid worse things to come. If you have seen doctors that were not able to give the answer, there is no reason for despair, it could be that standard healthcare were analyzing symptoms and they couldn't find any. But we know that many diseases make you feel miserable for no apparent reason, long before any symptoms show up, and when they do, they seem to be unrelated to the cause. A good example is a digestive disorder that you may not know you have, but it causes periodontal disease which, when it occurs is treated as an oral bacteria problem and fails to heal.

The family learned a few months ago that Dad would need assistance in his daily life. His slowly deteriorating health was making it difficult for him to take care of himself. They decided to move him to an assisted living facility for now and later as he became worse into a long term care facility. Before taking Dad to the first facility they contacted, they did some research first. One of the areas they found lacking in some units was the facility maintenance program.

Budgets have become tight due to many causes. Many of these facilities have to find areas to cut back. Daily support such as dietary needs are prioritized needs while the facility maintenance of the building does without the needed updates.

Assisted living facilities are treated more like home maintenance than institutional maintenance. The difference from a normal home maintenance is the amount and type of residents. Incontinence and wheelchairs or walkers often cause destruction in the rooms. Regular maintenance is needed to keep walls, carpets and baseboards clean or repaired for the safety and sanitation of the patients.

The HVAC, sprinkler and fire systems are complicated and must comply with local regulations. These regulations call for regular inspections of the systems. Without routine preventative facility maintenance in the budget, these homes can be closed if the systems are not kept up to code.

Regular routine maintenance needs to be done to keep the facility safe. It is recommended to change filters in heating and cooling systems, keep the coils clean and checking sprinkler systems routinely. Keeping the current system well maintained lengthens the life expectancy of the unit.

Maintenance workers should be qualified in what they do. They will be interacting with the residents so they should be good at making the residents feel safe and satisfied with the work. They are often called upon to assist in the changes in a room.

The family found an assisted living facility that met their needs. The home had a reasonable budget set aside for facility maintenance needs. When it came time to move dad into the facility, the maintenance team was called upon to put up shelves and move furniture so Dad could feel at home.

The maintenance team routinely checks the exits for accessibility. The lighting was checked often and new bulbs replaced as needed. The doors had been recently greased and the floors were free of cracks so their dad could easily navigate in his wheelchair.

Their dad enjoyed interacting with the maintenance workers. They often held special activities such as workshops for the men. This allowed them to talk about things they missed in their lives such as working with tools. The family appreciated the extra care and time the team spent with their dad.

The maintenance crew acts as a part of the caregivers. They provide extra eyes and ears because of their continued access to the resident units. They notice when the cupboard doors need repair or painting and see behavior changes in the resident. They can tell when a door is getting uncommonly heavy use, such as when a resident uses the door for support. They are all trained in first aid and CPR.

Assisted living facilities often have higher use than long term care units. Most residents are ambulatory and active. Higher activity levels lead to more intense maintenance programs to keep the building from going downhill quickly.

The family was pleased to find an assisted living home that realized keeping facility maintenance as a priority in their budget was beneficial to the residents.

Surprise! I am writing this article to tell you some good things concerning nursing homes. Since my associates and I have had the opportunity to visit numerous nursing homes and rehab centers and also numerous hospitals and numerous other medical centers and sections, I can give you a bird's eye view of something that is very important.

I am writing about the physical and occupational therapists -- who are working inside of nursing homes, hospitals and rehabilitation and care centers. This is probably one of the good things that can happen to someone inside of a nursing home IF they are able to access these treatments/training and exercise sessions. Once residents were allowed to actually go to the physical therapy room, and once they actually got their scheduled time with the therapists, the therapists worked hard and long hours to help the residents get independent.

Even in the very worst rehab center, the attitude and professionalism of the physical therapists and occupational therapists was never in question. The ones that I saw working with patients were doing their jobs and earning their pay, each and every day. I observed therapists working hard to help residents be successful in therapy. Most of them were polite, professional and hard-working EVEN in the most horrible rehab center. I have to say that and give them credit. These people were there to do a job and they did it. So the problems are not with that particular department inside of nursing homes.

I witnessed therapists helping patients using wheelchairs, walkers, and all sorts of mild sports equipment. They walked behind patients who were re-learning to use the walkers for the first time. Patient worked on all sorts of interesting rehab equipment.

So, ONCE the residents actually arrived,they could get good therapy once it was there turn. Problem is the waiting. And the waiting is not the therapist's fault, but it is the fault of administration and owners who do not properly supply the therapy equipment needed. So patients would need to take turns on various equipment and it the equipment was not ready, then patients would use other equipment.

Difference between good and bad centers:

In the bad centers, they had less than adequate equipment. And the ones they did have , they did not have enough of. In the good centers, there was great equipment and there was adequate equipment, so patients are not waiting their lives away for therapy.

In the bad centers, patients were told to line up at the elevators upstairs and wait until staff came to get them. THe process was slow, and painful. These residents were waiting their lives away. In the good centers, patients had very short waits if any.

IN ALL the centers, both good and bad:

Most of the physical therapists have not been damaged by the bad medical centers but if they stay there long enough (in the bad places), they will eventually have their reputations ruined. In some of the places, it seems that the physical therapists are the only really caring and concerned workers who are not goofing off. Most of the physical therapists that I spoke with or saw working with patients were giving excellent care. These workers are educated, informed individuals who seem to have a genuine concern for the patients that they work with. As they work, they see improvements day by day and that makes their work more rewarding.

Once I saw a person who began working in one of the better nursing homes progress from not being able to walk two inches to being able to walk for about twenty feet. So there is hope, progress and a good reason to attend physical therapy sessions at these places if you are stuck there as a patient. If you are thinking of going into the physical therapy occupation, you might want to investigate it more thoroughly, and get all the information you can get about schools in your location.