Healty Heart Tips

Everyday Heart Health Tips

If you're not convinced about the need to develop an exercise program for your life, you can at least try following some of these tips in your everyday routine. Take advantage of any opportunity for exercise. Try some today.

• Take the stairs instead of an elevator or escalator at school or the mall. Just start with one flight. Soon, you'll be ready for two.
• Park your car at the far end of the parking lot. The short walk to and from the store or school helps your heart.
• If you ride a bus or subway, get off a stop before your destination. Walk the rest of the way.
• If you can, spend a few minutes of your lunch break taking a stroll around the campus grounds. It should help you stay awake after lunch.
• Think of housework as an extra chance to exercise. Vacuuming briskly can be a real workout.
• Mowing the lawn, pulling weeds, and raking leaves are chores that can be done yourself as a chance to exercise.
• If you have a dog, think of the dog as an exercise machine with fur. A brisk walk with the dog is good for both of your hearts. Make it a part of your daily routine.
• If you have a family, schedule an after-dinner walk. Make it quality time.

SKIN CARE TIPS

For Glowing skin

• A facemask of egg white and honey gently removes the tan from your face.
• Mix oats with honey, yogurt and ground almonds. Apply this in your face, leave it for five minutes and wash with lukewarm water.
• Cucumber is a natural cleanser. Mix cucumber juice with milk and use it instead of a cleanser.
• For oily skin, apply a mixture of grapes, lemon and egg white. Leave it for 20 minutes and rinse with warm water. While lemon acts as a natural cleanser, grapes will soften your skin and egg whites will tighten it. Don’t be alarmed if your skin tingles.
• Cut the lemon and rub the wedge all over your face. Leave it for about 20 minutes, then rinse off with cold water. This will refresh your face. Avoid doing this if you have dry skin.
• Mix honey, lemon and vegetable oil .This mixture is a good moisturiser for dry skin. Apply this mask for 10 minutes.
• Apply the mixture of honey and milk on the face . This will make your skin glow.
• Prepare a mask by mixing a slice of pumpkin with egg yolk and milk. Let this mask set on your face for 30 minutes for a glowing skin.
• Mix half-a-cup honey to your bath water for soft and smooth skin.
• For a soothing body pack, prepare a paste of mint leaves and almonds. Mix it with warm water and apply all over your body. Leave it till it dries and rinse with warm water.
• Buttermilk dabbed on skin for 15 minutes will soak up oil from your skin without drying it.
• Carrot juice applied daily fades blemishes.
• For dark underarms and neck apply lemon juice mixed with cucumber juice and a pinch of turmeric daily. Leave this on for 20 minutes.
• For removing facial hair.. Apply a sticky paste of egg white blended with sugar and corn flour. When it dries, gently peel it off. Repeat this three to four times a week.
• Thin apple slices rubbed onto oily skin will help in controlling oily shine.
• For supple skin, apply a ripe smashed banana on your face for 20 minutes daily.
• Cauliflower juice applied on warts regularly will make them fall.
• For a fair skin, try this natural bleach. Mix orange peels (sun dried and powdered) with milk. Apply this paste for 25 minutes and wash off.
• Mix half teaspoon dried curry leaf powder with multani mitti (fullers earth) and apply on the face. Wash it after it gets dry.
• Apply the mixture of tomato juice and honey on the face and neck , wash it after 15 minutes.
• Apply the mixture of carrot juice and basin. Leave it till it dries and wash the face.
• Add two teaspoon of tomato juice with 4 teaspoon of curd and apply on the face.
• Add a pinch of yeast with 2 teaspoon of cabbage juice and apply.
• Mix 1 table spoon of barley powder with half teaspoon of lime juice and 1 teaspoon of honey. Apply it on the face and wash after 20 minutes.
• Mix pineapple juice and carrot juice together and apply it on the face and wash it after 15 minutes.
• Mix vinegar and rose water in equal quantities and apply.
• Mix curd and cucumber juice and apply it on the face.
• Apply the mixture of coconut water and thick pineapple juice.
• Make a paste with 1/2 teaspoon of milk powder, 1/4 teaspoon of egg white and 1/2 teaspoon of lemon juice and apply on the face.
• For dry skin, Make a paste with egg yolk, olive oil and lemon juice. Apply it on the neck and face, wash it out after 10 minutes.
• For oily skin, take a mixture of oatmeal and egg white and apply it on the neck and face
• For glowing skin, use basin or green gram powder mixed with milk instead of soap.
• Apply the mixture of raw turmeric and cream of milk on the face and wash it after 20 minutes. It will make your skin fair.
• Apply the mixture of honey, basin, cream of milk and olive oil as a face pack.
• Apply the paste of fenugreek with milk on the face and let it dry. Wash off with luke warm water.

• Make a paste of red sandal wood and apply it on the face every day for glowing skin.

• Make a paste with red sandal powder and coconut milk and apply on the face for soft skin.

The Long Tail of the EMR

In the fall of 2008 I had the opportunity to do some research on the, then dormant, EMR marketplace. The results came as no surprise. Most physicians did not have an EMR and were not interested in adopting an EMR due to cost and usability barriers.

Much has changed in one short year. Spurred by ARRA and its HITECH portion, there is a renewed interest for technology in the physician community. Some of it came from the promise of stimulus funds and some stems from the perceived inevitability of the need to have technology in one's office. There is no feverish anticipation of the great things an EMR will bring to a medical practice. Instead, there seems to be a somber resignation to the upcoming demise of a trusted friend: the paper chart.

On the other side of the market, vendors are gearing up for 2010. Since stimulus funds are supposed to begin flowing in 2011, the coming year is crucial to most vendors. There is a palpable sense of urgency for capturing market share before it is too late, and all physicians have made their choices. After all, once a physician buys and uses an EMR, changing vendors is not an easy proposition. Transferring clinical data from one EMR to another is practically impossible and the costs of change are high.

The HIT news is chockfull of announcements of mega deals almost every day. Mergers and acquisitions are rampant. Vendors are signing multi million dollar deals with large hospitals, medical organizations and regional healthcare groups to provide EMRs to affiliated physicians. At this point in the game, there are two vendors clearly ahead of the pack in the ambulatory market: Allscripts and eClinicalWorks. It is likely that the next months will add a few more contenders for large chunks of market share, most likely athena, NextGen and probably GE. These large corporations, most of them public, are very well poised to capitalize on the ARRA stimulus. They have the marketing power, the infrastructure and the ability to forge business agreements with equally large distribution partners that will lead to significant sales through 2010 and 2011.

However, the ambulatory EMR market has a very Long Tail.

Granted, the EMR market is not a consumer market per se. It has a finite size of a few hundred thousand customers and once a customer buys one EMR, it is very unlikely that he/she will be buying another one for at least several years. However, certain aspects of Chris Anderson's Long Tail theory still apply to the ambulatory EMR market.

Examining the current state of EMR adoption reveals that a handful of products are used by many physicians, while hundreds of others are used by very few, and some homegrown EMRs are only used by their creator and maybe friends and family. These hundreds of small to tiny products are the Long Tail of the EMR market and the tail has been getting longer and longer ever since HITECH became law. Unfortunately for small vendors, the tail has been also getting narrower at most points, and many existing small businesses, as well as new entrants, are hurting.

Few medium size vendors, in the thicker part of the tail, have been around for a while and are no better and no worse than the large players. Their survival will depend on finding ways to manage costs down and identify niches where they can provide unique service.

Then there are the newer web based, or internet based, EMRs. Most have price points significantly lower than the popular products. Unfortunately, the product quality in this group is not superior to the large EMRs. These vendors are most at risk of being wiped out by the bigger, better funded competition, who is also exploring the “cloud” based paradigm.

The homegrown products will likely always exist and serve the limited market they were designed to serve, with no major effect on the overall EMR market.

And then there is the exciting part of the tail, the part where innovation occurs. Tails are much better suited to breeding innovative solutions and the EMR Long Tail is no different. The tail contains several open source products that grow and innovate based on active user participation and distributed development efforts. These are worth watching. Other residents of the tail are attempting to formulate novel business models based on aggregation of smaller software packages, such as electronic prescribing, registries and patient connectivity. Some of these companies are veteran portal service providers adding new service lines to meet government regulations. DocSite, RelayHealth and Quest 360 are just a few. Others are trying to create entire platforms on which interchangeable software service providers can aggregate their wares. And then there is the entire Health 2.0 phenomena attempting to bring consumerism to health care, but that deserves its own separate analysis.

The takeaway for small vendors in the EMR space is that one can create a very profitable business in the EMR Long Tail. Physicians are not a homogeneous group of customers and it is very unlikely that that the utilitarian large EMR vendors will be able to satisfy the majority of the market. Multiple niche opportunities already exist in providing services tailored to particular medical specialties and various practice models, such as medical homes, concierge medicine, telemedicine, micro practices and more. More niche opportunities will be created by physician work-flow preferences and proliferation of non-physician providers. Tail companies that learn how to answer the needs of these niches by providing high quality solutions, while keeping costs of customization and service to a minimum, will thrive.

Since in the software world nobody stays on top for very long (except Microsoft), a disruptive enough technology breakthrough will eventually occur and the EMR market will be irrevocably changed, and the change will likely be brought on by someone from the Long Tail.

Margalit Gur-Arie was COO at GenesysMD (Purkinje), an HIT company focusing on web based EHR/PMS and billing services for physicians. Prior to GenesysMD, Margalit was Director of Product Management at Essence/Purkinje and HIT Consultant for SSM Healthcare, a large non-profit hospital organization.