Winter 2001 - Volume 5 Number 1

Clinical Contributions

Johann Gregor Mendel in the 21st Century: Genetic Science Fiction is Alive Today
Ronald P Bachman, MD; Edgar J Schoen, MD
This is a selective update of recent breakthroughs in a spectacularly active field. Topics briefly considered include the genome project, gene chips, diagnosis and prevention, pharmacogenomics, cloning, stem cell therapy, vitamins and birth defects, preimplantation diagnosis and therapy, and transgenic therapy.

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Clinical Management for Survivors of Sudden Cardiac Death
Michael R Lauer, MD, PhD
Death by cardiac arrest is potentially preventable in many cases and, thus, remains a major public health problem in the United States. The most common mechanism of reversible and preventable cardiac arrest is ventricular fibrillation. This article reviews clinical and electrophysiological aspects of cardiac arrest with emphasis on the use of the implantable cardioverter-defibrillator in survivors.

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Kaiser Permanente Medicine 50 Years Ago: Migraine, Histamine, Allergic and Other Related Cephalgias
Thurman B Dannenberg, MD;
Commentary by Joel S Richmon, MD|
The reprinted 57-year-old article by an early Kaiser Permanente physician about migraine describes clinical features, as well as the limited information then available about etiology and treatment. The accompanying current Commentary describes some current concepts about this common and still incompletely understood condition.

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Health Systems

Clinician Champions and Leaders for Electronic Medical Record Innovations.
Michael A Krall, MD
This is a very timely topic. As the organization considers the best method of designing and rolling out new clinical information systems, Dr Krall examines the characteristics of these change agent champions.

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Permanente Physicians Determine Use of New Technology: Kaiser Permanente's Interregional New Technologies Committee.
Mitchell Sugarman
An excellent description of KP's Interregional New Technologies Committee and the cutting-edge work that it has done. Clearly this is a Permanente competitive advantage.

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CIS Is Coming: Dr Andy Wiesenthal Talks About KP's Clinical Information System.
Jon Stewart, Associate Editor
Jon Stewart from The Permanente Federation interviews Dr Andy Wiesenthal on the programwide implementation of a colossal endeavor--implementing CIS!

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Clinician-Patient Communication: The Electronic Medical Record--Barrier or Bridge to Effective Clinician-Patient Communication?
Andrew M Lum, MD; Mark D Zuiderveen
Does having a computer in the exam room augment or detract from good clinician-patient communication? This is the inaugural CPC article for this new feature of the Health Systems section.

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Videoconferencing and CME: "Pearls of Wisdom" Learned From Ten Years of Experience.
Carol Havens, MD
Dr Havens describes the complementary role of videoconferencing in CME programs--truly a competitive advantage for Permanente.

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The Future of Continuing Medical Education (CME) Technology.
Carol Havens, MD; Suzanne Furuya, MPH, MBA; KM Tan, MD
This is a review of videoconferencing programs, KP's interactive CD-Rom and Internet-based learning. As the authors state, KP is becoming a leader in this type of CME activity.

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Is There a Role for the Physician in Technology Acquisition?
KM Tan, MD; John Howse, MD
In this article based on Northern California's experience, the key role of the Permanente physician is well demonstrated.

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Addressing the Challenge of New Medical Technologies: One Permanente Clinician's View--Part I.
Paul Wallace, MD
Dr Paul Wallace from the Federation's Care Management Institute does a masterful job framing the question of new technology integration.

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Editors' Comments

The Human-Machine Interface: Inviting Your Computer Into Your Patient-Clinician Relationship.
Tom Janisse, MD
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A Commentary on Technology and the Future of Health Care.
Mary Durham, PhD, Associate Editor
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New Technology--The Permanente Way!
Lee Jacobs, MD
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A Word From the Medical Directors

The Problem with Variation
Ronald L Copeland, MD, FACS

Dr Copeland provides a very concise overview of variation and the remedies provided by evidence-based medicine.
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External Affairs

Kaiser Permanente Online: What It Is
Alan Eshleman, MD, MPH
Of several Kaiser Permanente Web portals, KP Online is one of two that can be reached via the World Wide Web. It requires that the user be a Health Plan member who has registered and selected a password. When they visit the site, registered members are presented with five major options: 1) What's New; 2) Learn; 3) Explore; 4) Communicate; and 5) Using. Leading the medical community in building a virtual medical center, KP Online is a first giant step in improving the care of our members.

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Abstracts of Articles authored or coauthored by Permanente clinicians
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Book Reviews

"The Healthy Mind, Healthy Body Handbook" by David S Sobel, MD and Robert Ornstein, PhD.
Review by Katherine M Jakstis, MS
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"Beyond Managed Care: How Consumers and Technology Are Changing the Future of Health Care" by Dean C Coddington, Elizabeth A Fischer, Keith D Moore, Ronald L Clarke.
Review by Vincent J Felitti, MD
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Soul of Healer

Our Toddler
Robert Hippen, MD

"When it Hurts to Breathe"
Sharon Carter, MD

"Tongue Table"
Homer Carey

A Doctor's Dream
Robert Hippen, MD

Sharon Carter, MD

"Still Life"
Sharon Carter, MD


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