Using Technology to Prepare for Doctor's Visits

How much meaningful progress can you make in a 10- or 15-minute outpatient visit to your doctor? How much of that time might be spent on reconciling details (such as medication reconciliation – that is, what medications are you currently taking and not taking?) that could have been easily addressed beforehand so you can spend your precious time talking to your doctor about your active issues?

After scheduling a routine primary care visit, I was pleased to see that Kaiser Permanente understands this challenge and is using health information technology (IT) to address it. Within a couple days of scheduling my appointment, I received the following email message:

Upon clicking the link to take me to my personal action plan and logging in to the patient portal, I was presented with options to do the following under the "Actions for next visit" section:

• Check my medications: I was able to acknowledge whether or not I was still taking previously prescribed medications
• Complete lab work: it turns out that I had forgotten to get some blood work that had been automatically recommended for me, and nearby lab locations were provided
• Prepare for my vision visit: since I had also scheduled an optometry visit, a link to an eyeglass FAQ was provided so I could understand my options ahead of time

Additionally, the "Recommended media" section included the following data and resources:

• A video with general tips on heart-healthy diet
• An automated body-mass index calculation based on my most recent height and weight
• Tobacco use documentation, including status (never smoked, BTW) and last date of documentation
• Flu vaccination status (I'm immunized!)
• Pneumococcal vaccination
• Blood sugar
• Heart/stroke risk
• Blood pressure
• Medication list, including days left for current prescriptions along with refill dates and options to do the following:
• View my prescriptions
• Contact a pharmacist
• Email my doctor

For each of the above, there were links to additional information. This is all made possible by health IT and in my opinion is a far better approach to doctor's visits that trying to address everything in the clinic. That being said, the successful implementation of health IT is necessary but not sufficient to improve health status and maximize efficiency of the healthcare delivery system. We must also get people engaged in leveraging health IT resources to manage their personal health information and make the necessary lifestyle changes to lead healthier lives.  Have you done your part?

Facebook Safety Check

While many people would agree that social media sites like Facebook have utility limited to entertainment or pure suckage of time, one interesting feature is Facebook Safety Check which was designed to allow people to communicate during disasters. As Hurricane Matthew threatens the Caribbean and the east coast of the United States, I could see value in this sort of service. To illustrate, here is the Facebook Safety Check banner from the Hurricane Matthew South Carolina page:

What has been your experience with Facebook Safety Check, and have you used it to communicate with your friends and relatives during disasters?

Firefox on Older Macs

I routinely perform maintenance tasks on my parents' two iMac machines. This includes installing software updates (e.g., Adobe Flash, MS Office, Firefox), updating antivirus definitions, and removing tracking cookies/spyware. One of the machines is a mid-2011 2.5 GHz Intel Core i5 iMac with 4 GB RAM, running Mac OS X version 10.7.5.  I have not updated the operating system for fear that it would significantly slow down the machine.

When performing routine maintenance over the weekend, Firefox 48.0.2 showed me the following message:

The Learn more link indicated that Firefox support has ended for Mac OS X 10.6, 10.7 and 10.8. My options for continuing to use a secure version of Firefox were either to upgrade to Mac OS X 10.9 Mavericks or later (in which case I could install the latest version of Firefox) or to switch to the Firefox Extended Support Release (ESR) channel which will be supported until January 2017.

Since I didn't want to take the plunge by installing Mac OS X 10.9 just yet, I installed the latest ESR release of Firefox, currently version 45.4.0:

For the time being, we are on the safest version of Firefox, but between now and January 2017, I will need to decide whether it will be worthwhile to upgrade to Mac OS X 10.9.  Does anyone have Mac OS X 10.9 running on a mid-2011 iMac (or older), and are routine activities like web browsing, email, and word processing reasonably responsive?

RAW Photo Capture in iOS 10

I was excited to learn that iOS 10 supports RAW photo capture according to the Apple Developer iOS 10.0 prerelease notes where under the "Core Image" section it states, "RAW image file support is now available on iOS devices that use the A8 or A9 CPU"--hooray for my iPhone 6 Plus which has an A8 chip!  However, I was later disappointed to learn that RAW photo capture would not be available on my iPhone 6 Plus according to Table 3-1 in the Apple Developer iOS Device Camera Summary.  Only the iPad Pro, iPhone SE, iPhone 6s, iPhone 6s Plus, and later models would support RAW photo capture.  Wah.

Nevertheless, I am pleased to hear that many 3rd party iOS developers have already introduced RAW photo capture into their apps. Lightroom, 500px, and ProCam are a few examples. While they all tout editing features and RAW workflow within their mobile apps and the ability to export edited images in JPG format, I have not found any explicit language that the RAW DNG files could also be exported (eg, synchronized to the Apple Photos application and/or exported directly to the Mac operating system Finder).

Why am I interested in the ability to export the RAW files?  First, I prefer not to process my RAW images on a mobile device. Not only are mobile screens are smaller and less convenient for editing in general, there are times when I need to magnify an image to 1:1 such as to verify that the right amount of noise reduction had been applied, so there are significant advantages to using large monitors for RAW editing workflows.  Second, I use other desktop applications for photo stitching or HDR processing of my RAW files, and those apps might not be available on mobile devices, at least not yet.  Third, I simply want to archive my original RAW files so I have the option to later go back and apply more edits, using any software application that fits the job (which will usually be a desktop application).

So... does anyone have a RAW-compatible iOS 10 device, and could you tell me if you are able to use a 3rd party app to export the native DNG files to your computer?