Eocene Diet Follow-up

Now that WHS readers around the globe have adopted the Eocene Diet and are losing weight at an alarming rate, it's time to explain the post a little more.  First, credit where credit is due: Melissa McEwen made a similar argument in her 2011 AHS talk, where she rolled out the "Cambrian Explosion Diet", which beats the Eocene Diet by about 470 million years.  It was probably in the back of my head somewhere when I came up with the idea.

April Fools day is good for a laugh, but humor often has a grain of truth in it.  In this case, the post was a jumping off point for discussing human evolution and what it has to say about the "optimal" human diet, if such a thing exists.  Here's a preview: evolution is a continuous process that has shaped our ancestors' genomes for every generation since the beginning of life.  It didn't end with the Paleolithic, in fact it accelerated, and most of us today carry meaningful adaptations to the Neolithic diet and lifestyle. 

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Soiled Sport's 2012 Fat Ass Series, Run #1

Divide by Zero: Weird Math in CMS Clinical Quality Measure (CQM) Criteria

From the CMS "Medicare Electronic Health Record (EHR) Incentive Program - ATTESTATION USER GUIDE For Eligible Professionals (EPs)" (warning: large PDF), page 41/64:

... Step 25 – Core Clinical Quality Measures (CQMs 1 of 3)

EPs must report calculated CQMs directly from their certified EHR technology as a requirement of the EHR Incentive Programs. Each EP must report on three core CQMs (or alternate core) and three additional quality measures. If one or more core CQMs is outside your scope of practice, you will have to report on an equal number of alternate core CQM(s).

If the denominator value for all three of the core CQMs is zero, an EP must report a zero denominator for all such core measures, and then must also report on all three alternate core CQMs.

If the denominator value for all three of the alternate core CQMs is also zero an EP still needs to report on three additional clinical quality measures. Zero is an acceptable denominator provided that this value was produced by certified EHR technology.

Now, while I had an "800" in the math section of the SAT, where I believed that a fraction with a denominator of zero had a value of either infinity or 'undefined', that was many moons ago. Perhaps my knowledge of mathematics is now obsolete...

Wait - I tried this simple program on an old Microsoft MS-DOS GWBASIC interpreter, ported ca. 1981 to the Intel 8086/88 from Bill Gates' original 8080-based MBASIC, that I have laying around on my PC:

10 INPUT X
20 LET Y=X/0
30 PRINT Y
40 END

and got this warning/error message, right from Bill Gates:

"Division by zero"

and the answer: 1.701412E+38 (infinity in the 8/16-bit world from where GWBASIC sprang).

So ... allow me to say I find CMS math just a bit puzzling.

Wait ... now I understand.

Infinite quality! :-)

But thank heavens the zero denominator is only accepted when produced by 'certified' health IT.

Uncertified health IT is liable to produce a denominator of "i" (that is, the square root of -1).

-- SS

Addendum: since I am not a government math genius, I checked with Wikipedia:

... A common fraction (also known as a vulgar fraction or simple fraction) is a rational number written as a/b or , where the integers a and b are called the numerator and the denominator, respectively.^[1] The numerator represents a number of equal parts and the denominator, which cannot be zero, indicates how many of those parts make up a unit or a whole.

-- SS

Addendum:

This post is partly satire. I was a day late for April 1 but...

-- SS

Is Atkins the Schticky of the Diet World?

About a month or so ago, I started seeing infomercials for the Schticky.  That whack Sham Wow guy is back hawking the reusable silicone lint roller.  There's a similar product being peddled by the heir to the late Billy Mays.  It struck me as funny because I have one of those things around here somewhere.  My inherited pack rat gene does not allow me to throw the thing away though we never use it.  It's something we have courtesy of the hubs' ex, so I know it is at least twenty years old.  

Which got me thinking about the Atkins diet and low carbing in general.  And the name "Schticky" brings with it its own connotations vis a vis one Gary Taubes use of the word schtick in describing scientists.  The similarities are many:

• It works very well the first time on most things
• It has come back after a hiatus from the "As Seen on TV" world
• It doesn't work as well after you wash it, especially if you don't let it dry fully before using it the next time
• It comes with a 10 year warranty implying it will work for the long haul.  (For the record, mine still works, but it's not been used more than a handful of times for all these years)
• It works well on lint, but the promoters over sell it for all sorts of uses it would be inefficient to use it for
• Having one in the house keeps you from buying one of those good old fashioned masking tape style rollers that work every time for the original purpose so long as you have a fresh sheet on them.
• There's the Schticky and then there are knock-offs

As Fatman's sidekick boy wonder Glucagon was trying to explain why obesity hasn't been cured even though low carbing has been around for eons, I couldn't help but think of the Schticky.  Why would anyone have anything else if this thing really did deliver on all the promises -- and all for $19.95!!  Waging his war on insulin, Peter Attia MD (never practiced medicine after residency) is the new Vince Offer (that's the crazy Sham Wow dude's name) of low carb.  He was the co-sponsor of Taubes' publicity stunt wherein between the petition and many who left comments essentially bemoaned how Tara Parker-Pope was 60 lbs overweight because she just hadn't applied the right cure.  Perhaps she should try a Schticky to remove the fat ;-)  As I tweeted, Attia misses the point.  Atkins has (a) been around forever, and (b) been repackaged and resold over and over and over.  And yet not only has it not replaced the need for any other approach to weight loss, the landscape is littered with "users" left wanting.  Much like that Schticky in my drawer ...

University of Arizona Medical Center, $10 million in the red in operations, to spend $100M on new EHR system

In my Oct. 2006 post "$70 million for an Electronic Medical Records system?" I wrote:

... healthcare doesn’t have the capital for clinical IT misadventures, and I believe when the issues become more public in this industry sector and information flows about mismanagement and abuses (as is happening in the UK ’s Connecting for Health project) [now abandoned as described here - ed.], the fallout won’t be pretty.

Here's an example of an organization in profound ardent technophile-driven Ddulite mode:

UA Medical Center to spend $100M on new records system

Tucson's largest health-care organization expects to spend upward of $100 million on getting its two hospitals talking to each other.

Right now, the inpatient medical record systems at the University of Arizona Medical Center's two campuses aren't speaking to each other.

The lack of communication is resulting in more work for healthcare providers in the University of Arizona Health Network.

[How much more work, exactly, and how much would a non-cybernetic solution cost? These issues seem never to be mentioned - ed.]

The $1.2 billion, nonprofit company employs nearly 7,000 people.

The network is installing a new, uniform electronic medical records system for all patients at its two hospitals - UA Medical Center - University Campus and UA Medical Center - South Campus - and at outpatient centers as well.

... Project leaders predict it will result in a more efficient organization with fewer medication errors and better patient care.

... The new system's benefits will certainly trickle down to patients, said Clint Hinman, an experienced pharmacy director within the network who is directing the computer upgrade program.

[Note once again the absolutist statements of deterministic benefit and beneficence, based on scant supportive evidence and increasing contradictory evidence, that I bolded above - ed.]

I note that $100 million+ is probably enough to pay for AN ENTIRE NEW HOSPITAL or hospital wing ... or a lot of human medical records professionals.

Executives and project leaders have probably never read any of the literature at the reading list here or at my academic site here, or if they have, choose to be blind to it and trusting of literature such as ONC's sloppy-science "should not have been published in its present form" health IT cheerleading here.

Most important of all:

It's not advisable to gamble with $100 million in that fashion, especially under these conditions:

... BUDGET ISSUES

Spending $100-million-plus on electronic medical records is a lot of money for a network that as of mid-January was at $10 million in the red in operations, BUT network spokeswoman Katie Riley said the electronic medical records are not to blame.

[Capitalization and emphasis of the "but" mine - ed.]

This statement is both representative of a healthcare system gone overboard - you don't spend on luxuries when you're $10 million in the red - and is a non-sequitur.

Who cares if the EHR's are not to blame for the system being $10 million in the red? That does not seem like a good reason to go ahead and spend $100 million (which will probably balloon to several times that figure, hence I will use $100 million++) on a very risky gamble.

Further, all it will take is a few of these mishaps to put the system further in the red.

I should also ask: will medical and other staff be laid off to afford the new systems, in effect trading people for computers?

To spend $100 million++ on HIT when you're already $10 million in the red on operations is, in my view, financially reckless.

-- SS