Ambulances in Guangzhou, China, are getting a facelift. The ambulances are being outfitted with computers and internet service, which will allow for easier communication with doctors in hospitals. The ambulances are also receiving global positioning systems (GPS) which will help them to be able to determine the quickest routes to the hospital, traffic jams, accidents, and congestion.

These technological advances should make health care in South China's Guangdong Province much more cutting edge. I wonder what is being done elsewhere in the world that is comparable?

In a great stride toward making medical records electronic, and more uniformly accessible, nine hospitals in New York City are making identification cards available to about 100,00 patients. The cards are designed to have computer chips in them, which is no real surprise: You can buy a teeny tiny memory chip for your palm pilot now that holds as much as a gigabyte of data. So why not create a card or a a jumpstick even for patients?

The cards will contain information about the patients, medical records, allergies, complications, where they live, background, health histories, current medication, etc. The hospitals will be able to check the cards then when patients come in for check-ups or procedures, and all of their medical records will be available immediately. This should reduce a lot of medical errors, reduce time waiting for records to be faxed.

The possibilities for this are endless. I can see a day when all of us carry such a card, beginning with those with chronic health problems who already sport medic-alert bracelets.

A Boston girl, 11 years old, lies in a vegetative state, surviving only via life support. She was profoundly abused by her adoptive mother, and the woman's husband. Her mother, facing rampant criminal charges, is dead from a murder/suicide with the girl's grandmother. So now, with the entirety of the charges against him, the girl's so-called stepfather would like to have a say in her health care... as if he hasn't had enough of a say already.

The man is arguing in favor of continued life support, even though the girl's brain stem is gone, due to the abuse at her caregivers' hands. Critics say he doesn't want to face murder charges if she dies. The girl's birthmother wants to let her go. It's a tragic, complicated legal nightmare, and I can't help but think it is made all the more so by the silent technology of life support.

If I were choosing a college to attend today, I would definitely consider Minnesota State University. The university administrators recently coordinated their campus's exercise facility and Information Technology department and made their exercise equipment computer-capable. Now, those who feel torn between homework and exercise don't have to choose. They can type a paper while they are working out. Don't think that people can't do this either; I know I could do it.

For those who aren't quite that coordinated (or, as in my case, determined), they can still check emails or surf the net. Some students on campus will be able to take quizzes for their health sciences classes while working out. However, at least one personal trainer doesn't like the new technology because she thinks working out should be a break from working. But I think this is great for people who previously thougth they had to choose-- or never made the choice of exercise.

Dr. Robert Pearl makes a valid point: we can computerize our banking records, even in my small town, and make them available online. Why can't we do this nationwide in every hospital for patient medical records? Dr. Pearl is the CEO of the Permanente Medical Group, which is leading efforts to computerize records in Northern California. And for Pearl, it's personal.

Pearl lost his father to medical error two years ago: doctors missed the fact, in medical records, that the senior Pearl had not been given a simple vaccine that would have saved his life. My own mother was a victim to pharamaceutical error a few years ago. She was given an incorrect dose of prednisone for rheumatoid arthritis which caused her multiple side effects and caused permanent vision damage before the error was corrected.

Of course, and as usual, the problem comes down to money: How do we pay to have patient medical records made availabe online? But this would revolutionize health care nationwide and beyond, if patients were traveling or moved and their doctors could access records simply and electronically. Imagine how many lives could be saved.

As a follow-up to Heather's story about a French woman who recently required a face transplant, the initial results are good. The woman can eat, but not speak yet. Surgeons literally grafted portions of another woman's face onto her head in this groundbreaking surgery. Of course, as with any transplant, it will be awhile before it can be truly determined whether or not her body will accept the face; she will have to take drugs for the rest of her life to prevent rejection.

The woman had a partial face transplant, of only her lips, nose and chin. Doctors said that reconstruction of the woman's face after she had been attacked by a dog would not solve the primary problems: eating and speaking. Recontruction could help aesthetically, but not practically. Heather also noted that the medical community is in an uproar about the ethics of face transplants: will people only choose the very beautiful? Will this procedure succumb to vanity? However, the most serious issue at hand is that of rejection: What kinds of problems will this woman have if her body rejects her new face? And how will it be rectified?

What do you think? If this operation is successful, should face transplants become more commonplace? Do you have problems with the potential for vanity operations? Personally, I do not anymore than I have problems with plastic surgery. Aesthetic operations are risky and sometimes foolish; however, if someone donates their body to science and doesn't have a problem with their face being recycled, I say, go ahead.

 A complicated and risky procedure, which nonetheless shows great promise in the treatment of movement disorders, may gain a little help. Deep Brain Stimulation (DBS) relies on the insertion of electrodes deep into the brain to treat such disorders at Parkinson's, multiple sclerosis, and obsessive-compulsive disorder.

A South Korean researcher, Dr. Hwang Woo Suk, apologized and resigned Thursdasy November 25. Dr. Hwang was "the first scientist to clone a human embryo and then extract stem cells from it." Any research involving human tissue, particularly embryos and stem cells is ethnically charged. There are too many perceived risks that embryos will be created and then donated to research, which religious groups find a violation of human life. Therefore, there are strict guidelines for how such research is conducted.

In Korea, it is illegal both for egg donors to be paid for their eggs, and also for members of research teams to donate eggs to their own projects. However, according to Dr. Hwang, both of these scenarios took place among his project members; a hospital administrator paid other egg donors more than $1000 each for their eggs to boost donations. Dr. Hwang said the donations occurred without his knowledge.

A new prenatal test for Down syndrome, the test which has been determined to be highly effective for all women, it not without its drawbacks. Namely, that people with Down syndrome and members of the National Down Syndrome Society are aware of the test, and also of its implications. These prenatal tests provide information to prospective parents; however, to what end?

How would you feel if you had a certain trait or characteristic that some people were aborting in order to avoid? The people who contributed to this article did not seem to regret being born, nor the children they had given birth to, who had conditions such as Down's, cystric fibrosis, mental retardation, and bi-polar disorder. However, the article claims that as many as 80% of women who find out they are carrying Down's babies abort. This is not to say, however, how many women proceed with such prenatal tests.

All of this raises the ethical question: Just because we can obtain medical information, does that mean we should? On the other hand, should we deny women information that may help them determine whether they want to continue a pregnancy? Women in this country, so far, as still guaranteed the legal right to obtain abortion. Are we denying them their rights if we refuse to develop technologies that may inform their decisions better? These are not easy questions to answer. What do you think?

Strict religious groups such as Hasidic Jews, some Orthodox Jews, and Catholics are cautioning members against internet use. However, some devout members are challenging leaders by pointing out that despite some of the immoral dangers of the internet, it can provide many benefits, including the realm of medical informatics.

Not only are medical records more organized and easier to maintain with web technology, which allows for the transfer of records among practitioners, but also, medical billing companies offer careers for members of these highly religious groups (and other people, too). Therefore, as with many things along the way, the internet is creating struggles between tradition and progress, and it looks like once again, technology may have the upper hand.

The cost of making airplanes ready for wi-fi are incredible: $500,000 per plane, not to mention grounding the plane for two weeks while it is being outfitted. So far, only the Boeing 737-400 "Popsicle" (an orange and white plane) seems to have wi-fi. It is available to passengers for $9.95. I would pay that fee to have internet while I fly. I flew Friday from Missouri to Pennsylvania, and lost a business day of posting for these blogs because of my lack of wi-fi on the long flight.

Airlines need to make a profit from having wi-fi on the planes. However, the technology won't benefit just business travelers like me. It will also improve telemedicine, making sure that not only can doctors stay in touch with clinics long distance, but also that if medical emergencies arise in the air, computers can be used to aid in treatment. It will probably be awhile before we can sign on to the internet midflight, but I can see the writing on the wall. And it's exciting.

Next, I'd like to see wireless available when I'm in my car on cross-country trips... Can you imagine what that would do for telemedicine?

Neurosurgeons are trying to get the word out that an innovative new surgery can save limbs from amputation. Unfortunately, only a handful of surgeons can perform the surgery at this time. One courageous mother found about about them though. Her 19-year-old son was in a car accident that literally wiped out the nerves in his left arm. While her son was in a coma, the determined mother prevented physicians from amputating.

It was determined that nerves from donors could be grafted into his arm, and about seven inches worth of missing tissue in his legs. His mother turned out to be the closest match. Surgeons took nerves from both of Frankie Anderson-Harris's arms and legs to gather tissue for the surgery. As a result, she will suffer from permanent numb spots on her feet and elbows, a sacrifice she happily made.

Former Speaker of the House Newt Gingrich is a strong advocate for computerizing hospital records. According to Gingrich, hospitals need to be kept to the same standards as airlines because there are thousands of deaths due to medical record error annually.

An added benefit of electronic medical records would be that patients would be able to use interactive websites that would allow them to compare their medical records other potential medications to see whether there are side effects or other contraindications. Such applications could revolutionize healthcare.

Senator Conrad Burns, a republican from Montana, has proposed legislation that would protect patients' health care coverage. Medicare patients who receive care at telemedicine locations will be reimbursed for health care which would not ordinarily be covered.

The legislation will protect patients across state lines, and in urban centers, not just rural and underserved populations. Additionally, the bill will provide telemedicine coverage to practitioners including speech and language pathologists, occupational, and physical therapists. Given the movement toward more satellite medical centers, this additional coverage is welcome indeed!