Syphilis in Oregon shows 1500% increase – Proactive providers steps to protect patients

The Centers for Disease Control (CDC) and the Oregon Health Authority (OHA) have recently posted a bulletin for all Oregon healthcare providers due the massive increase in syphilis cases since 2007 – from fewer than 30 cases reported in 2007 to about 450 cases statewide during 2015. Providers should be on alert to provide intake forms that may capture a need for further screening. Because you can’t tell by simply looking at a patient whether or not they need testing, certain behaviors may suggest a need for screening. Providers should take a good sexual and drug use history from all patients.

To read the full text of the bulletin and get more information on Oregon’s fight against sexually transmitted diseases visit the Oregon Health Authority’s Public Health page at

Weight loss programs may prevent lumbar spinal stenosis

A recent cohort study indicates that assisting arthritic, obese patients with weight loss programs may signal better outcomes to both prevent onset and assist with improved surgical outcomes with lumbar spinal stenosis. Obese and overweight persons are at a higher risk for developing LSS (lumbar spinal stenosis). Furthermore, results indicate that obesity might be a novel explanation for the increased number of patients with clinical LSS. Weight loss provides a good treatment option that may deter LSS onset and produce better surgical outcomes.

My computer isn’t a phone charger?

It’s quite common to walk through an office (medical or otherwise) these days and see cell phones connected to computers via a USB cable. The most likely cause? The phone needs to be charged and there’s not a wall outlet or adapter available. But are they any safety and security concerns that providers should know about this practice?

As it turns out, there are some issues that you need to be aware of when connecting your phone to your computer, even if it’s just to charge it. Some phones are recognized by the computer as a small, portable hard drive; others will request that software be installed to manage the phone. Either of these two scenarios can create security issues and concerns. has a section devoted to Mobile Device Privacy and Security that covers topics including management of mobile devices, frequently asked questions, case studies, and information on protection and encryption of mobile devices. If you or your staff use mobiles devices in your practice, we encourage you to visit to obtain more information about this topic.

Another good reason not to charge your phone via USB on your computer? The power flow from a USB drive is not consistent and can cause the battery on your phone to degrade prematurely.

Surgery for Your Lumbar Spinal Stenosis Patients?

In two studies, outcome predictors for lumbar spinal stenosis surgery shows a distinct initial improvement in activities of daily living and decreased pain the first four years following surgical intervention. However, these good effects begin to gradually deteriorate over year 5, 6 and 7; until by year 8, these randomized controlled groups, are nearly indistinguishable, with respect to symptoms.

According to the study’s lead author, Dr. Jon Lurie, “This may not fundamentally change how the process of shared decision-making should happen, but it adds new information to that process. For spinal stenosis, the pros and cons of surgery are very individual and related to the severity of the disease and the limitations of the individual, what the individual likes to do, and how well he or she is able to manage disease symptoms.”

Long-term outcomse of lumbar spinal stenosis: eight-year results of the Spine Patients Outcomes Research Trial (SPORT)

Surgery versus physical therapy for treating lumbar spinal stenosis

Looking for chiropractic practice information?

If you’re a chiropractor looking for practice information and guidelines on a variety of chiropractic-related topics, with links peer-reviewed articles on integrative healthcare, original blog content, and integrative healthcare resources, check out (registration may be required to access certain features). This site, started in 1995 by a group of chiropractors who wanted to feature the “best information and communication possible”, offers original content blog posts on integrative healthcare topics, (Chiropractic Reaches Consensus on Terminology for States for Care), as well as literature synthesis and integrative healthcare resources (Low Back Pain and Chiropractic section).

Review all they have to offer at

To meat or not to meat, that is the question?

Recent well-publicized concerns about the consumption of processed meats such as bacon, ham, and sausage as a link to increased risk of colon cancer has us all wondering, is this the end of “everything is better with bacon”? The evidence as explained in the March 30, 2015 and November 3, 2015 editions of TheUpshot by Aaron E. Carroll helps to provide some balance to this ham-bashing.

Best Practices: HIPAA and Mobile Devices – Part 2

Are your mobile devices secure when it comes to protected health information (PHI)? Here are some tips to expand your awareness in this area. These tips and more can be found on, an excellent HIPAA resource for providers!

Can I use texting to communicate protected health information, even with another provider or professional?
It depends but generally no. Text messages are not secure because they lack encryption. Even if your device is encrypted, you still cannot be certain your text message was received by the intended recipient. If texting is an important means of communication for you there are third-party solutions available; diligence in researching their compliance is a must.

What do I need to consider when using my mobile device in public?
Public Wi-Fi is unsecured. Working from a local coffee shop, for example, to perform billing or charting would not be not a good idea. On that same note, do you let employees catch up work from home, like billing or charting? If yes, do you know the security of the PHI that may be downloaded on their personal devices? What is your company policy on employees using their own equipment to perform office work?

Do I need to be concerned about talking to my office staff via Bluetooth?
Yes. You must be sure to know your cell phone capability in this area. Many phones have a “turn off” or set the Bluetooth capabilities to “non-discoverable.” In this mode, the Bluetooth-enabled mobile device is invisible to other devices not authorized to access or monitor the data in your device.

Note: Please consult with a security and privacy professional for advice and guidance for your specific situation.

Less May Be More: Breast Cancer Screening Recommendations & Changing Physician Behaviors

Transparent evidence-based recommendations for appropriate breast cancer screening provide the best approach to early detection while minimizing the costs associated with false positives. With respect to the issues around breast cancer, this may involve doing less – and it’s very difficult to get physicians to do less. Review the current recommendations here and read about the challenges accompanying the implementation of a less-may-be-more approach.

Best Practices: HIPAA and Mobile Devices – Part 1

Are your mobile devices secure when it comes to protected health information (PHI)? Here are some tips to expand your awareness in this area. These tips and more can be found on, an excellent HIPAA resource for providers!

What privacy and security safeguards should you have in place on your mobile device before communicating with a patient?
Encryption is strongly recommended. This is a method of converting an original message of regular text into encoded text, rendering a low probability of assigning meaning unless the user has the “key”. If you have encrypted your mobile devices make sure you know who in your office has access to the “key” to encryption. You? Your office manager? Is the “key” kept in a secure location?

Is encryption required by HIPAA?
No. In HIPAA language, this standard is “addressable” and not “required”. “Addressable standards” within HIPAA must be implemented if “reasonable and appropriate” to do so. The bottom line is if you choose not to encrypt your mobile devices you must have documentation ready to show a HIPAA auditor why you opted not to.

Is encrypting my mobile devices expensive?
No. Many phones and laptops have encryption capabilities (varies by device). If your phone or laptop computer does not have this capability, there are applications you can download or purchase – just be sure it is from a trusted source! We recommend checking for more information on this topic.

Note: Please consult with a security and privacy professional for advice and guidance for your specific situation.

Cut the risk of cold, flu transmission this winter

As we enter fall and winter here in the Pacific Northwest, we find ourselves spending more time indoors, increasing the rates of transmission of cold and flu viruses. Because our patients touch many surfaces and many instruments and hands touch our patients, standard precautions tell us to be alert to all these exposures for both patients and providers. In order to reduce the risk of exposure and transmission, consider these helpful tips:

  • Over-the-counter chlorine wipes (brand or generic) destroy most bacteria and viruses on smooth surfaces with one application. The surface must be left wet and allowed to air dry for four (4) minutes for complete cleaning. There are many surfaces that should be cleaned frequently throughout the day, including door handles, restroom doorknobs/handles, arm rests, countertops, community “sign-in” pens, and community use keyboard/mouse/work stations. It is also important to remind everyone to avoid touching their eyes, nose, and mouth thereby limiting contact related transmission to themselves.
  • Everything and everybody our hands touch carry risk: risk of transmission, infection, and injury. Handwashing is good for limiting that risk but in a busy practice may irritate your hands. Alcohol gels are easier to apply between routine exposures and should be available throughout the office for patient and providers. Use of an alcohol-based gel will also alert you if you have any sort of open lesion on your hands in which case a glove will be a safer option.
  • Tools and supplies used in practice need to be sterilized or replaced. For example:
    • Chiropractic tables should have paper covers for areas that a patients face may touch. These should be changed out for each patient.
    • Gua Sha tools made of ox horn do not sterilize well because they are porous. Replace them with metal or resin tools.
    • Cupping tools of glass or plastic can be sterilized with chlorine wipes.
    • Hot rocks used in massage need immersion in appropriate cleaning liquid.
    • Topical gels and lotions for massage should be accessed by squeeze bottles or pumps (with regular surface cleaning) rather than open jars where cross-contamination can occur between providers and patients.

Need more info on limiting the exposure and transmission of viruses? The Centers for Disease Control has an excellent page here with data supporting their handwashing recommendations as well as health promotion materials. McKesson offers their UPrevent site with infection prevention guides.