Physicians writing on KevinMD about the technology in the exam room: the electronic record and what it did to the visit, meaningful use, alert fatigue, pajama time, human and AI scribes and whether they give time back, ambient documentation, telemedicine, and what AI can do in clinical practice now and who is responsible when it is wrong. Two maintained records draw on this archive: The electronic health record: what physicians say, in their own words and Artificial intelligence: what physicians say, in their own words.

It’s time we get the technology working for the patients, and not make their lives more difficult

Health Technology
September 17, 2019

In a world where, in a moment, I can order from thousands of items and have them delivered to my doorstep the same or next day at the press of a button without having to re-enter my name, address, and billing information each time, it would seem that filling out paper forms at the doctor’s office by hand to have someone else re-enter the information into a computer that doesn’t …

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It’s time we get the technology working for the patients, and not make their lives more difficult

If you spend more than 80 percent of your day staring at a screen, you are no longer a doctor

Health Technology
September 16, 2019

The use of health care information technology has increased exponentially over the last five years, and as a frontline physician, I have seen this change at close quarters. In most of the hospitals I’ve worked in up and down the East Coast, it’s been interesting to observe this transformation. The process has usually started with nurses and then moved on to encompass doctors. It’s overall a good thing, as I Read more…

If you spend more than 80 percent of your day staring at a screen, you are no longer a doctor

Virtual scribes are game-changers for physicians

Health Technology
September 16, 2019

Today was like no other day. It was our first day together.

Me and my “virtual” scribe — an actual person who seems to “virtually” to exist inside of a Jabra speaker on my desk and so subtlety that I forgot to mute a few times when not seeing patients. The “man” in the Jabra speaker now knows just how long of an appointment I need for my hair, and that …

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Virtual scribes are game-changers for physicians

5 clinician concerns about OpenNotes

Health Technology
September 12, 2019

More than 200 health organizations have now implemented OpenNotes. Many more are piloting, are soon to implement — or have implemented, and we don’t know it! For more than three years I’ve been fortunate to represent OpenNotes to potential implementers, and I’m confident I’ve heard almost every clinician concern or anxiety regarding what might happen when patients read their own notes.

Here are the five most common concerns I’ve heard — …

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5 clinician concerns about OpenNotes

How does this tech improve patient care?

Health Technology
September 11, 2019

What if each new feature of your medical record came with a description of how it would improve patient value, not just how to use it? Could a simple checklist help to achieve Annals’ vision of putting patients first by helping to ensure that health care innovators release only those features that help us improve patient value? Could a simple checklist help organizations reduce …

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How does this tech improve patient care?

A slow death by charting

Health Technology
September 10, 2019

It’s 10 p.m.

Seven days before Christmas.

I’m sitting at work “finishing” up some charts.

I am suddenly overcome with anger.

What am I doing here right now at this minute? I am helping no one.

This work I’m typing away at — trying so hard not to scream — it’s hoops. Fucki*g hoops … for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian …

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A slow death by charting

How telemedicine intersects with AI, social media, and precision medicine

Health Technology
September 6, 2019

Telemedicine will eventually become a more prominent part of our clinical practice, with the incorporation of artificial intelligence (AI) and social media and networks, and integration with precision medicine in electronic health records. As clinicians and scientists, we should be thinking about where and how these four innovative strategies intersect, so that we can continue to not only contribute to the conversation and direction of these strategies, but also lead …

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How telemedicine intersects with AI, social media, and precision medicine

Can entrepreneurial geriatrics fight ageism in health care?

Health Technology
September 3, 2019

Ageism in health care abounds. Older adults are often overtreated or undertreated for various conditions. The presence of things like fatigue, chronic pain, arthritis, and even cognitive impairment are often accepted as “normal” parts of aging — by physicians and patients alike — despite the fact that many are preventable.

According to a recent opinion piece by NBC News, “We medicalize the natural process of …

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Can entrepreneurial geriatrics fight ageism in health care?

Just because EMRs can document everything doesn’t mean they should

Health Technology
August 29, 2019

It’s always kind of a surprise when you read a patient’s chart, and you see an examination of a body part they just don’t have.

Just the other day, I was reading a consult note on a patient of mine who had been seen by a subspecialist for evaluation of a serious issue, and I received back a long detailed office …

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Just because EMRs can document everything doesn’t mean they should

Adopting the DoorDash model to health delivery

Health Technology
August 21, 2019

I was reading an article in The New York Times entitled, “The Rise of the Virtual Restaurant.” More and more people, particularly in urban settings, are using apps like Uber Eats, Grubhub, and DoorDash to bring fresh, warm food directly to their doorsteps.  Mr. Lopez, the virtual restaurant owner featured in the article, had no chairs, no tables, and no menus.  His virtual restaurant was actually four restaurants in one that were …

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Adopting the DoorDash model to health delivery

5 ways to lessen the physician burden in the product evaluation process

Health Technology
August 15, 2019

Keeping tabs on the sheer volume of medical drugs and devices on the market is nearly impossible – the FDA approved a record 105 novel medical devices and 59 new drugs in 2018 alone. At the same, hospitals and physicians face ever-growing pressure to cut costs while improving quality. Many physicians make patient treatment decisions based on their own expertise and/or limited review of the readily accessible information, the processes …

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5 ways to lessen the physician burden in the product evaluation process

The limitations of artificial intelligence in cardiology

Health Technology
August 11, 2019

Artificial intelligence (#AI) seems to be all the rage these days, as it should be, given its potential to revolutionize medicine in many ways. #AI is actually already an integral part of many of our lives on Google, Amazon, Facebook, and other sites. Siri and Alexa use #AI too, so we can’t easily escape it. Why would we want to?

Of course, one concern about the algorithms is that they often …

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The limitations of artificial intelligence in cardiology

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When an EHR is hacked by Russians

Health Technology
August 10, 2019

Hippocrates didn’t have a server.

In 2012 our practice invested $300,000 into building computer infrastructure and the purchase of a brand-spanking-new electronic health record, commonly referred to as an EHR. The mandate for this purchase was brought forth from the federal government with the intent to improve overall health care communication.

Since this expenditure, terms like image server, ethernet, firewall, hyperlink, backup server, IP address, fax queue, cache server, LAN, domain server, …

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When an EHR is hacked by Russians

How have EMRs changed the doctor-patient relationship?

Health Technology
August 5, 2019

I have penned several posts on the pitfalls of the electronic medical record (EMR) system that we physicians must use.  Indeed, I challenge you to find a doctor who extols the EMR platform without qualification.  Sure, there are tremendous advantages, and the ease of use has improved substantially since it first came onto the scene.  But, keep in mind that these systems were not devised and implemented because physicians demanded them.  To the contrary, …

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How have EMRs changed the doctor-patient relationship?

5 steps to fix our EMR disaster

Health Technology
August 1, 2019

The EMR has become a focal point in the physician burnout discussion. Although I believe EMRs are a necessary evil, current iterations of them are just not good. Each click on a mouse is a prick on the many good souls that figuratively bleed until they are physically and mentally burned out. Scribes are not a solution either. That is just a workaround. EMRs are one of many things that …

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5 steps to fix our EMR disaster

When physicians focus more on screens than patients

Health Technology
July 29, 2019

As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen.

“It just didn’t feel very personal,” Lee said. “I didn’t feel heard.”

It seemed as though keeping a record of the conversation was more important to the doctor than making a connection with Lee.

It wasn’t the experience she wanted, but she …

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When physicians focus more on screens than patients

A medical student reviews Eric Topol’s Deep Medicine

Health Technology
July 28, 2019

Following on the heels of The Creative Destruction of Medicine and The Patient Will See You Now, Dr. Eric Topol has published his newest book, Deep Medicine, earlier this year. While the first two books highlight how technological disruption will first digitize and then democratize medicine, his newest is about deep learning, and how artificial intelligence (AI) has the potential to ultimately deepen the patient-physician bond. It …

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A medical student reviews Eric Topol’s Deep Medicine

How technology ruined, and can save, the doctor-patient relationship

Health Technology
July 16, 2019

Each year, Medical Economics surveys physician readers to find out what irks them most. Topping the latest list: insurance paperwork, followed closely by electronic health records (EHRs).

The reason is the same for both. Insurers and EHRs get between doctors and their patients.

When it comes to medicine’s computer problem, the obstacle is literal. Doctors sit behind a screen, focused on the EHR and not the patient. …

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How technology ruined, and can save, the doctor-patient relationship

Patients: Take back your health information. Here’s how.

Health Technology
July 16, 2019

Have you ever wondered why your personal health information essentially belongs to your health care provider or institution? I mean: why do they keep your information under lock and key, and you have to sign a release to get it? After all, it’s your blood that they just pulled out and tested, it’s your body they just shot up with X-rays or operated on — and you paid for these …

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Patients: Take back your health information. Here’s how.

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