Tech

What physicians can learn from anthropologists

Tech
March 3, 2019

Since the passing of the Health Information Technology for Economic and Clinical Health (HITECH) Act in 2009, it has been said that health tech would dramatically revolutionize health care and the patient experience. Advocates have claimed time and time again that it would advance disease diagnosis capabilities, improve patient outcomes, and increase patient satisfaction. Belief in this narrative can be seen in the sharp increase in health tech investments, with …

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Must-have medical apps for primary care

Tech
January 23, 2019

Earlier this year, we put together a list of what we thought were the best medical apps for health care providers. Now at the end of 2018, we’re augmenting that list to give you a full picture of what we think are must-haves medical apps for those in primary care.

Safe Motherhood Initiative: ACOG DII SMI

Quick reference for common obstetric emergencies

Many of us in family medicine practice full-scope …

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Is your smartphone leading to burnout?

Tech
November 22, 2018

Burnout and dealing with its symptoms has become a hot topic in the last decade. It’s a problem that has multiple contributing factors. Some of those factors are thrust upon us and are beyond our control, such as government regulations. Other factors are self-imposed, and thus under our control, such as volunteering for extra call shifts. One self-imposed factor is a little thing we use to improve our lives, our …

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The one patient that drives physicians to burnout

Tech
September 9, 2018

We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways.

Who’s that patient for me? Let’s just call him Elton Reed.

Oh, Mr. Reed … where to begin with him?

When we first met, I remember being so excited and energized by him. He just had this fresh feeling …

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Why more physicians should enter industry

Tech
June 30, 2018

Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences — and their encompassing companies — all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why?

Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement …

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How to create an app as a physician

Tech
June 24, 2018

“There’s an app for that.”

The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users.

Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to …

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Clinical plagiarism: the problem of copy and pasting in EMRs

Tech
March 26, 2018

It is all too common for a section in a progress note to look something like this:

# Aspiration pneumonia:

  1. Continue vancomycin 1 g bid
  2. Continue Zosyn 3.325 g q6h
  3. Follow-up blood cultures
  4. Follow-up sputum cultures
  5. MRSA nares screen negative
  6. Blood cultures negative
  7. Discontinue vancomycin

Yesterday, a version of this note (lines 1 to 5 to be precise) had my name on it. Today, it is signed by someone else. Read it …

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Poor communication between EHRs is unacceptable. Let’s fix it.

Tech
February 16, 2018

The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even …

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Technology is not friendly to the elderly

Tech
November 2, 2017

In about 1990 we got our first computer. I say “we” because my husband and I shared a desktop which I used infrequently. I mostly used it for word processing, and the Internet was very young. At the turn of the millennium, my children were using computers, and they were limited to 1 hour of computer time a day, which was on a shared desktop. By 2001, I was communicating …

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I left medicine to become an entrepreneur

Tech
July 25, 2017

I have wanted to be a pediatrician since I was eight years old. Growing up, my favorite book was the large medical encyclopedia that sat on the bookshelf in our den. My life has been planned around that singular goal, each step predetermined and in a very specific order. I have thoroughly enjoyed practicing medicine over the last 17 years — first as a primary care pediatrician, then for the …

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Recognize the importance of the physical exam in the history of medicine

Tech
April 9, 2017

A patient comes into the ER complaining about throbbing migraines after falling off her bicycle; thus, the physician quickly orders an X-ray, complete blood count, and asks the nurse to schedule the patient for an MRI of the head and neck in case both those tests come back inconclusive. As an ER scribe, I saw many conditions where the physician would quickly do a physical exam, and then use a …

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Are you ready for a recording device in your exam room?

Tech
February 26, 2017

During residency, one of my patients brought a tape recorder to his appointment.  It was a big bulky old tape recorder, that was antique technology ten years ago.  He was older and wanted to record his appointment so he could remember every detail.  His children often called him and wanted an in-depth report of all of his medical visits.  He decided he would audio-record his appointments and send the tape …

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5 obstacles to texting patients

Tech
November 1, 2016

The business value of medication adherence tools is coming into focus.  For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale.  That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products.

The poster child for …

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Here are the limitations of virtual doctor visits

Tech
May 21, 2016

Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon.  Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.

One way to think of …

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This doctor orders pregnancy tests on men. You’re probably doing it too.

Tech
March 27, 2016

I order pregnancy tests on men. In fact, I do it pretty frequently.

Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since.

Despite this, I still order pregnancy tests on men.

Perhaps …

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The bait and switch of health care IT

Tech
November 21, 2015

Last week I was playing golf with some friends. The Boston area has been having a bit of an Indian summer, and we are lucky to still be getting out there (long may it last). The conversation during one of the holes turned to health care information technology, when my friend, who is also a physician, told me about his experiences with a (certain famous) new electronic medical record that’s just been installed in their …

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This epic EHR video may save our relationship with patients #LetDoctorsBeDoctors

Tech
October 19, 2015
YouTube video

I have a love-hate relationship with the electronic health record (EHR).

To be precise, it’s 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages.

I’ve been in practice long enough to straddle the transition from paper … to even more paper (thanks EHR, you’re the …

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When doctors stalk their patients

Tech
October 16, 2015

I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for …

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It’s time to remove EHR gag orders. For patient safety’s sake.

Tech
September 29, 2015

I recently read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.”  The article states that, despite massive public funding of electronic health records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who purchase their systems. We are talking about gag clauses that prevent criticism by …

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