OSCAR EMR meeting Feb 20, 2020 Notes

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Here are the notes from the latest Mini-Conference put on by Dr. Ian Pun.

SYGMA 1 and 2 demonstrate that as-needed treatment with budesonide and formoterol prevented exacerbations and loss of lung function, significantly reduced median daily ICS dose, but was less effective than the other treatments for symptom control. Treatment should aim for symptom control or exacerbation prevention.

Query by Example : Find your patients prescribed Ventolin over the last year.
Please in ADMIN -> Query By Example

select de.last_name, de.first_name, dr.demographic_no, dr.written_date , dr.special from drugs dr, demographic de where (dr.special like “%ventolin%” or dr.special like “%salbut%” or dr.BN like “%ventolin%” or dr.BN like “%salbut%” ) and dr.demographic_no = de.demographic_no and dr.written_date > date_sub(curdate() , interval 1 year) order by dr.demographic_no;

COVID-19 epidemiology

Ontario Public Heatlh cases of COVID-19

Map of COVID-19

Realtime COVID-19 Stats

Mathematical model of COVID-19 spread

show how to change parameters
incubation period = 7 days
when the infection started = Nov 15, 2019 (backtracing of curve)
when the control measures started = Jan 24, 2020

The infectivity of the R0 ( patient spread before control) = 2.3
The infectivity of the Re (patients spread after control= 1.5
Actual reports cases fit curve of Re = 1.9

Use my OSCAR RbT “free-text” search for “wuhan” patients.  I found and contacted a patient who is a flight attendant from Wuhan China, she told me about the situation first-hand starting a month ago (this is her latest email shown below with her consent)

Hello Dr pun ,

Thank you for your email . I am in Dubai now . Now we cannot fly to mainland China so we have to find other destinations as alternatives .

My family in Wuhan are all well . My parents have been staying at home since Jan 23rd . My brother buys groceries for them once a week .

I do have friends have lost their family members and one friend got affected herself , as well as her daughter . Hubei is still in serious
shortage of masks and other essential protection gears . My doctor friends told me that she had her coworkers have to stay at
hotel in case they get the virus。

Air Canada tentatively plan to resume China flight the end of March but not confirmed yet . There will be no flights to Hong Kong
in March due to booking reduction.

Hope the situation can get better soon .


Computer Security
Ransomware: a sustainable, profitable business

Phishing Email is now directed to healthcare. Lifelab , Toronto East General hacked last October
After cfpc.ca email hacked on Feb 5, my OSCAR server started to experience have hacking attempts.
Anti-viral software not much use.

Don’t click on suspicious links
Use secure passwords
Review your security policy of your OSP

AI skin classifier that classifies a skin picture to 7 categories!

My OSCAR app using Google Tensorflow trained on HAM-10000 skin lesion library.

We tested it on one of the attendees! It’s a benign mole on your face!

Exporting charts in bulk you must check with OSP.  Check the ownership of the clinic.

Chart transfer with pdfs or XML

emailing charts to lawyers or insurance with Keke ZIP with password.   Renaming file to .zap as some mail filters it out.

Next meeting April 9, 2020

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