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Who Is On Your Team? November 10, 2011

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals, EP Physicians.
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Since the dawn of organized medicine, health care delivery has witnessed many changes in the evolution of organizational and professional structures to benefit patient care.  However, it seems that our present economy, regulatory, and social changes have combined to make this the single most uncertain time in modern medical history. (more…)

How Do Allied Professionals Fit into HRS September 23, 2011

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals.
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Have  you ever wondered how Allied Professionals (AP) fit into the governance structure of the Heart Rhythm Society (HRS)? There are allied professional members of many committees and subcommittees. These members are nominated by committee chairs and ultimately appointed by the incoming president of HRS. (more…)

Should We Wiki? July 5, 2011

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Science & Research.
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A few weeks ago, the BBC World Service reported on a survey of European physicians concerning their use of Wikipedia. As it turns out, 60% of those surveyed use Wikipedia as a medical reference tool.

This garnered much snickering in the media as reporters immediately went to the street to solicit public opinion. As it turns out, some of the public were apparently surprised that health care professionals don’t know everything about everything. In the public’s defense, I have met some health care professionals who don’t realize that they don’t know everything about everything.

The media did raise the reasonable question of whether a resource without stringent peer review should be included as a source of medical information for professionals. What do you think? Do you ever use Wikipedia as a resource? Which instant references do you use to navigate our entropic world of EP knowledge? How should we – as EP professionals – determine which references are valid enough to use on the spot?

Sketcher App. Love it. May 19, 2011

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Atrial Fibrillation (AF), Education, Society News.
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HRS Sketcher

The Heart Rhythm Society debuts new desktop and iPad application for heart rhythm professionals.

My friends will tell you that I’m a technology junkie. They’re right. And, I’m really a sucker for a good app. So when Larry Stern, the Heart Rhythm Society’s Vice-President of Education, asked what I thought about the HRS Sketcher, an app that is available for heart rhythm specialists to use with patients, I was enthusiastic. A few months later when Larry asked if I’d be willing to test the new app that the Society had developed…. Let me just say that there was a cartwheel involved. (more…)

Talking With Gadgets May 18, 2011

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Scientific Sessions.
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While attending Heart Rhythm 2011 in San Francisco, I observed that EP has finally evolved from being gadget-driven to being gadget-facilitated. iPhones are ubiquitous, and iPads are de rigeur. In the Exhibit Hall, the theme seemed to be connectivity. We don’t just want new toys to drive; we want new toys that talk to each other. (more…)

Remote Device Monitoring in the Real World June 16, 2010

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals.
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I was in Philadelphia last weekend for an advanced level allied professional educational program. Along with outstanding lectures from experts and local faculty, program attendees raised some excellent points and questions about providing high level electrophysiology care challenging practice environments.

One interesting topic focused on how to incorporate remote device monitoring into practice workflows. (more…)

Expanding NP Services: Effect on Heart Rhythm Care April 23, 2010

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals.
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Are you a nurse practitioner? Do you work with one? In a recent post about transitions in health care policies, Dr. Amit Shanker mentioned the issue of scope of practice. Have you ever wondered why nurse practitioners and physician assistants function so differently at different institutions? It’s partly due to practice and institutional policies, but even more closely related to state legislatures. That’s right: scope of practice is determined by your elected state legislators.

Twenty-eight states are currently considering expanding nurse practitioners’ scope of practice to alleviate the national shortage of primary care physicians and provide care for the estimated 32 million Americans who will gain health insurance in the next few years.  These state-level policy changes would reflect health reform legislation including nurse practitioners as medical home providers. (more…)

Be More Critical April 9, 2010

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Science & Research.
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Josh Cooper recently discussed the shortcomings of the gold standard we use to generate new knowledge and understanding: the randomized controlled trial. He pointed out that patient populations may be significantly divergent from the patient sitting in front of us, and study findings may not be right for our particular patients.

I agree with Josh’s comments, and propose a solution to deal with the randomized controlled trial, and all studies for that matter. No matter what your grandmother told you, or what you’ve been working on with your therapist, when it comes to research, BE MORE CRITICAL.

Critical appraisal of research doesn’t mean criticism of the table layouts, or the trial sponsor, or the study PI. Critical appraisal means a careful look at the patient population, study design, and research intervention. Did the conditions in the study look like the conditions that I’m facing when I treat my patient? If not, are they similar enough that I can learn something that will help me take care of the patient in front of me? (more…)

Providing Quality Care to Patients While Pushing Buttons March 9, 2010

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals.
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 Some days I feel like I just push buttons. No, I’m not reliving my teenage years when I tormented my parents. I’m referring to checking devices in outpatient clinics.

Pacemakers and ICDs have become wonderfully intricate. We can program for, or around, almost anything. We have pages of diagnostics to review. We have numbers to analyze, recalls to review, and spreadsheets to populate. Ain’t technology grand?  But, what about the patient?  During all of our button-pushing, do we forget that there is a patient underneath the programmer wand? On the other end of a remote monitoring transmission? Generating an electrogram interesting enough that we took out calipers? (more…)

What’s Missing from the Autopsy March 1, 2010

Posted by Heather M. Ross, DNP, ANP-BC, CCDS, CEPS, FHRS in Allied Health Professionals.
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A few months ago, one of my neighbors died suddenly. I didn’t know her well, but I knew that she was a healthy 40 year-old mother of young children. I wasn’t close to the family and struggled with the role I should take with her husband and children. Of course, unexpected death in a young person raised my SCA antenna, but would it be prying to insert myself into her family’s grieving process?

I weighed my “nosy neighbor-ness” against my clinical knowledge that sudden cardiac arrest could have implications for the children, and reached out to the family by e-mail.  Her husband responded to my offer of assistance very quickly. Indeed, her death was unexpected and unexplained. He asked if I would review the autopsy report with him when it was available. 

And then I heard nothing, until last week when my widowed neighbor e-mailed me with the autopsy report that he had just received. (more…)

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