Blogging lessons from the EPA

(beautiful representation of blogging using Moo cards by mexicanwave)

With thanks to @barbchamberlain on Twitter today (even though she works for the enemy, go DAWGs) I learned about a great blogging guidelines resource that Environmental Protection Agency (EPA) employees consult when writing for their group blog, Greenversations.

I want to know who wrote these guidelines because s/he desperately needs to be heard by other .gov agencies who have group blogs. The more I think about it, these need to be heard by every blogger, not just those participating in .gov or other group blog situations! Do you blog for work or tackle issues in your blog? Substitute your employer or own identity in for the EPA and consider their guidelines. In particular, these points resonated strongly with me (bold mine):

For each post, consider the following questions:

• What's the nature of the problem you're working on?
• How does your personal or work story relate to the problem?
• What are you doing to come up with a solution? What are the benefits to the reader? (essentially, why should the reader care?)
• What progress has already been made?
• How does this fit into EPA's overall mission of protecting human health and the environment?
• What can the reader do?

and

You should not:

• Simply repeat EPA Web content or use your entry as a new EPA Web page
• Announce program activities or opportunities unless you are coordinating with a news release or other mechanism
• Mimic news releases
• Overwhelm the reader with facts and figures. Keep it simple and link to more details.
• Violate the cautionary areas {discussed in PDF}

Greenversations is a blog of beauty not only due to visual design and helpful information and navigability, but a venue I'd love to see more often that includes a clear About section that includes

This blog is written by EPA employees (and occasional guests) about the things they bring to their jobs every day. The opinions and comments expressed in Greenversations are those of the authors alone and do not reflect an Agency policy, endorsement, or action, and EPA does not verify the accuracy of the contents of the blog.

To put it another way, this allows EPA employees to be themselves and not press release & policy-spouting clones of their employer. The employees still follow very straightforward, clear and sensible guidelines subject to official review that does not include censorship of their personal ideas, yet still gives them the credibility to blog as an EPA.gov.

I'm not an expert about group .gov bloggers but I'm going to do some more research to see if I can find similar ones with clear guidelines and freedom of expression. If you already know of some, please share here?

Foreshadowing: Women *are* cutting back on healthcare due to cost

In the pre-Thanksgiving blog post where I encouraged you to talk about health with your family (you did, right?) I theorized

I suspect with our current economic climate even more moms will choose health care for their children first and postpone their own due to the expense.

Little did I know that there was a survey in progress by the National Women's Health Resource Center (NWHRC, at healthywomen.org) about this very topic that was released yesterday with some sobering news about women and healthcare.

• 45% of the women have failed to seek medical care in the past year (including doctor's visits, recommended medical procedures & medications) because the cost was too high, with Hispanic women more likely (58%) than white (43%) or African-American (42%) women.
  
  
• More than 40% reported their health had declined over the past 5 years, mostly due to stress and weight gain.
  
  
• Only 42% mentioned feeling prepared to grow older in terms of financial security, with financial (51%), retirement (46%), medical (42%) and health insurance options (41%) given as information needs.

On the positive side, women feel more positive about aging and named Tina Turner as the celebrity over age 50 that they admired most. Rock on!

NWHRC has created an online wellness information resource for women in response to the findings of the survey. At a quick glance I'm finding a few broken links in this consumer health resource, but I definitely encourage checking out De-stress the Holidays. It's a bit too late for all the long range planning tips (10 weeks) but there are gems in there that could still be done such as "If certain rituals trigger sadness, change them or create new traditions to replace them."

Friday Foolery #5: 3 centuries of ginger, antibiotics & MRSA

These are some of the contents of a medicine chest, circa 1820, housed at the British Columbia Medical Association Medical Museum that I learned about on Wednesday thanks to Morbid Anatomy. If I ever make it to New York in my lifetime, I will visit the Morbid Anatomy Library because a project with a mission to 'survey the interstices of art and medicine, death and culture' sounds like a kindred spirit to me. I can't watch MedlinePlus surgery videos without getting queasy but could study still life artistic depictions of disfiguring diseases, dissections & death and never be bored.

Speaking of queasy, I'm not sure how the ginger was prepared in the 19th century for the medicine chest but a 21st century preparation of it in lollipops (Preggie Pops, which have now evolved to drops) helped me function well enough that I never had morning sickness at work. Laudanum is ethanol with opium (yum!), and the other medicine chest contents are

Goulard's extract [a solution of lead acetate and lead oxide], paregoric elixir [a camphorated tincture of opium], spirits of nitre, oppodeldoc [a mixture of soap in alcohol, to which camphor and sometimes a number of herbal essences, most notably wormwood, were added] and ether.

100 years after this medicine chest there were numerous innovations in the field of medicine such as the discovery of insulin, vitamins and the (re-discovery of) penicillin. Check out the accomplishments of the Nobel Laureates of that era in addition to the (re)discoveries details, then note the following from the Antiseptics page with a header of How Germs Get Used to Antiseptics, 1921

VARY YOUR ANTISEPTICS; otherwise the disease germs will get used to them. The distinguished French physician and bacteriologist, Charles Richet, has recently laid before the French Academy of Sciences a note on researches made by him, together with Henry Cardot, on acquired characteristics and heredity in microbes. He experimented, among other things, on the influence of antiseptics, to determine especially whether bacteria may acquire immunity to toxic substances in the same manner that the higher animals do.

It's 2008, and methicillin-resistant Staphylococcus aureus (MRSA, or mer-sah... one of a handful of acronyms where you don't say each individual letter out loud) is a real threat due to exactly what Dr. Richet was warning the medical community about regarding antibiotic resistance almost a century ago.

According to the Centers for Disease Control (CDC), there are over 12 million doctor visits for skin infections by American patients annually and half of them turn out to be MRSA. Please know the symptoms to watch for & check out the National MRSA Education Initiative for more information.

NAHIT vs. medical librarians for PHR: Advantage NAHIT

Back on June 16th I shared what the National Alliance for Health Information Technology's (NAHIT) workgroups proposed for uniform definitions for healthcare information infrastructure, including the personal health record (PHR).

On October 15th, the National Network of Libraries of Medicine, Southeast Atlantic Region (NN/LM SEA) shared what a joint task force of the Medical Library Association (MLA) and the National Library of Medicine (NLM) proposed for the definition of an PHR.

Let's compare the two:

NAHIT

Personal Health Record (PHR): An electronic record of health-related information on an individual that conforms to nationally recognized interoperability standards and that can be drawn from multiple sources while being managed, shared, and controlled by the individual.

MLA-NLM Task Force

Electronic Personal Health Record (PHR): PHR is a private, secure application through which an individual may access, manage and share his/her health information. The PHR can include information that is entered by the consumer and/or data from other sources such as pharmacies, labs, and care providers. The PHR might or might not include information from the electronic health record (EHR) which is maintained by the health care provider and is not synonymous with the HER. PHR sponsors include vendors who may or may not charge a fee, health care organizations such as hospitals and health insurance companies, or employers.

Both are written as found with no editing or emphasis from me. I'm assuming HER in the latter quote is a typo, and one I may understand the origin of since I recently attended a forum (will blog about it soon!) where Word kept auto-correcting EHR to HER and it nearly drove me insane.

When it comes to explaining what a PHR is to the general public and not other people in the medical field, librarianship or information technology, I'm not sure either definition will be sufficient as a stand alone. I see a stronger possibility of "...what?" being their response to the one from the medical librarians with 4 sentences and 3 variables vs. NAHIT's single sentence with no variables.

I studied Pogue's Anti-Jargon Dictionary and think NAHIT's 'interoperability' may fall in alignment with his 'Functionality' complaint. Clarifying the 'multiple sources' as being healthcare-related would help so it's not totally arbitrary. The Social Security Administration will not suddenly suddenly plunk your disability information in your PHR... at least I hope not.

On the other hand, we in medical librarianship are fond of calling people 'consumers'... so why did the definition include both 'individuals' and 'consumers' for describing the same population? Was it really necessary to include all the 'and/or', 'might or might not', 'may or may not' variables up front for a basic definition? Why are we mentioning an electronic health record (EHR) in the definition for a PHR without also defining an EHR beyond something 'maintained by the health care provider', thus putting prior assumption on the consumer/individual to know exactly what that entails?

I am all for promotion of consumer health resources as part of PHR applications, but what exactly is the 'information assistance statement' that is being sent to these organizations to include in PHRs?

Am I a traitor to my field in respectfully disagreeing with the members of the joint task force about their definition for PHRs and wanting to use NAHIT's?