KIDSCARE LINK USERS: We recently discovered two problems with KidsCare
Link involving access by community physicians. In the first case, users
were frequently exiting the browser and not logging out of the application
first. Before long, we had reached the maximum number of users allowed by
our licensing agreement with Microsoft. A patch has been applied to
resolve this issue. However, we want to remind you to log out of the
application when you are through searching for information by clicking the
“Log Out” icon in the top right corner of the screen. Using the log out
also ensures the confidentiality of any data that you have viewed.
The second problem relates to HBOC (our internal system) and the
designations of primary care provider. This results in your inability to
find some patients with the usual search method. You are then required to
use the First Access to find a patient. This is a problem that Epic is
working on and we expect a fix with the release of their next group of
system upgrades in late January or early February. Meanwhile, please be
patient with us and use the First Access functionality. Questions? Call
Janice Cobb at 937-641- 4556.
OSELTAMIVIR (TAMIFLU) RESISTANCE PROMPTS NEW RECOMMENDATION FROM THE CDC:
On December 19, 2008, the CDC issued interim recommendations for the use
of antivirals in the treatment of influenza. Although influenza activity
has been low early in the season, testing done on 88 H1N1 strains
recovered nationally reveals that 98 percent are resistant to oseltamivir.
The CDC discusses the options and the recommends the following:
• Review local or state influenza isolate data for influenza A, to
determine if disease is prevalent, if the isolates are A or B, and if any
A isolates are H1N1 or H3N2.
• Use diagnostic testing that distinguishes between A and B (of note our
testing does so).
• If positive for B, treat with oseltamivir if over age 1 (see CDC
guidelines at www.cdc.gov)
• If positive for A, use of zanamivir is recommended (only for children 7
years of age and over who do not have any contraindications to use of
zanamivir). Oseltamivir alone could be used if local surveillance
indicates that circulating strains of virus are H3N2 or Influenza B. For
a child less than 7, a child with chronic lung disease, or a child who
cannot use the inhalation device, a combination of oseltamivir and
amantidine could be used for treatment.
You can help us track what is in the community by ordering influenza
cultures on children with classical influenza. This would allow us to not
only identify the isolate as influenza A, but further determine if it is
an H1N1 strain or an H3N2 strain. CDC guidelines provide specific dosages
of drugs by age and by influenza strain. For more information, please
visit the CDC’s website at
http://www2a.cdc.gov/HAN/ArchiveSys/ViewMsgV.asp?AlertNum=00279.
Questions? Call Tom Murphy at 937-641-5871.
PRIMARY CARE PHYSICIAN (PCP) NOTIFICATION OF ALL ADMISSIONS: We are
working on a new strategy that will allow us to notify the PCP of all
admission to Dayton Children’s, even if admitted to a specialty service.
Review of the system will occur at the professional staff executive
committee meeting this week, as well as at the medical directors meeting.
If approved, we hope to implement this new process by February 1, 2009.
This is a direct result of feedback that we have received asking for more
consistent and prompt notification. This system will provide notification
within one day of all admissions. The exception is that calls will not be
made on Sundays, since offices are closed. We will attempt Saturday
notification for those practices with Saturday hours. Questions? Call Tom
Murphy at 937-641-5871.
CME online
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