Thursday, February 27, 2003

Using the Internet to Treat Jet Lag A Brief Report in the March 2003 issue of Psychiatric Services discusses the use of the Internet to automate and facilitate treatment. Daniel Z Lieberman, MD of George Washington University conducted a study of 20 participants who followed an automated treatment regimen for jet lag and tracked their treatment via the website.   Although the number in the study is small, Dr. Lieberman points out that “over an eight-month period, more than 4,600 individuals visited the site, which suggests that interest can be generated by simply making a treatment publicly available.”  He avoided the security issues by not asking for any personal information.  He points out that the  project was designed to highlight some of the issues involved in delivering treatment over the Internet. “The management of jet lag was chosen because calculating a complex light-exposure schedule is well suited to a computer” and the risks minimal. Although there are numerous shortcomings in this brief study, the concept is fascinating and clearly others will follow. Dr. Lieberman discussed these findings in a presentation entitled "Internet Treatment of Jet Lag" May 2002 at the American Association of Technology in Psychiatry meeting in Philadelphia. Dr. Lieberman's site. 10:35:31 PM    comment []

Mobile Phones in the Hospital For many years, staff and visitors in hospitals everywhere have wondered why there is a ban on cellphone use. If you ask, the response is usually that ‘it interferes with some of the electronic equipment.’ If you press for a real answer, no one seems to know – and they just repeat the first vague response. A commentary in the the current Lancet points out that it is time to lift the ban.  The authors point out that “almost 10 years after the ban's introduction, there remains an absence of evidence of any real risk to patients' safety. Although a few studies provide some support for the current policy, most investigators have been more sceptical about the actual risk posed. In a 6-month survey of mobile phone interference in a hospital ward, Hietanen and colleagues found no evidence of equipment failures. Irnich and Tobisch tested medical devices used in intensive care units for electromagnetic interference from mobile phones, and concluded that "prohibition of mobile phones in hospitals is based not on real evidence, but on an intellectual and precautionary impression without knowledge of susceptibility of the devices". They further argue that "prohibition of mobile phones in patient wards is not justifiable in terms of patient safety". They continue by pointing out that the digital phones that we currently use are more sophisticated and certainly less potentially ‘dangerous’ than their analog predecessors and finally, they make the point that patients and visitors and medical staff are, in fact, using cellphones all the time. Time to drop the ban? Call me on my cell and we can discuss it. Lancet: Volume 361, Number 9359 9:50:12 PM    comment []

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