Health Technology

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.

How can data analytics to improve the care and outcomes of cancer patients?

J. Leonard Lichtenfeld, MD

Health Technology

July 11, 2019

I want to share some thoughts about artificial intelligence, or as I prefer to call it “data analytics.” Fundamentally: How can we capture the capability of analytics to improve the care and outcomes of cancer patients? And more importantly: How can we harness this technology to help bring back the human touch in cancer care?

Admittedly that’s a large focus covering lots of opportunities. Speak to one expert, and you will …

Technology is corrupting the culture of medicine

Robert Pearl, MD

Health Technology

July 2, 2019

To help then-candidate Bill Clinton remain focused on the No. 1 voter issue ahead of the 1992 presidential elections, political strategist James Carville coined an unforgettable mantra, which he posted inside Clinton campaign headquarters.

It read, “The economy, stupid.”

The quote became famous both for its edginess and wisdom, reminding us to separate the big picture from everything else.

In health care, it can be hard to define the “big picture” issue when …

Electronic health records cannot replace a doctor who knows you

Richard Gunderman, MD, PhD and James Lynch, MD

Health Technology

July 1, 2019

The introduction of electronic health records (EHRs) was accompanied by a great deal of fanfare. Such systems, which replace old paper-based charts in doctor’s offices and hospitals, were designed to make patient data more accurate, safer and more accessible. It was also claimed that they would make it easier for doctors and other health professionals to monitor medical care and ensure that guidelines were followed. The federal government was so …

Smart beds and sleep apps: Don’t sleep on their data collection practices

Julie Appleby

Health Technology

June 10, 2019

Your bed could be watching you.

OK, so not with a camera.

But if you have any of a variety of “smart beds,” mattress pads or sleep apps, it knows when you go to sleep. It knows when you toss and turn. It may even be able to tell when you’re having sex.

Sleep Number, one company that makes beds that can track heart rate, respiration and movement, said it collects more than …

Would you trust Alexa with your patient data?

Elisabeth Rosenthal, MD

Health Technology

June 6, 2019

Amazon has opened a new health care frontier: Now Alexa can be used to transmit patient data. Using this new feature — which Amazon labeled as a “skill” — a company named Livongo will allow diabetes patients — which it calls “members” — to use the device to “query their last blood sugar reading, blood sugar measurement trends, and receive insights and Health Nudges that are personalized to …

How non-video telehealth can be a cure for overprescribing antibiotics

Ray Costantini, MD

Health Technology

May 15, 2019

When Dr. Fleming found penicillin mold in his Petri dishes in 1928, he had no idea of the impact he — and it — would have on global health. Penicillin and the antibiotic revolution that it triggered have saved countless lives and change world history.

Less than a century later, though, antibiotics occupy a space between savior and sinner. This complicated reputation is mostly due to how …

Electronic medical record interoperability is a total mess

Fred N. Pelzman, MD

Health Technology

May 14, 2019

Just the other day, while I was in the middle of seeing a morning schedule full of patients, I opened one patient’s chart and was thrilled to see a whole bunch of new icons in Chart Review in the electronic health record that I had never seen before.

These apparently indicate office visits and other health care encounters with outside providers.

Sometime during …

Are we making artificial intelligence biased?

Iyesatta Massaquoi Emeli, MD

Health Technology

May 12, 2019

The tale is told of a large realm, of 1.4 billion, the largest nation in the world. It has a culture that is old, rich and grounded. A citizen’s worth can be understood, determined, exalted or decried. In modern times said country has a visionary leader for life. His foresight includes the automation of culture through the use of big datasets, mass surveillance, facial recognition, and artificial intelligence. A citizen’s …

The effect of mobile devices on our collective psyche

Paul Pender, MD

Health Technology

May 3, 2019

During a recent walk at Crystal Cove, a splendid California State Park with miles of pristine coastline, I encountered two young women sitting on a bench with a magnificent view of the ocean. Yet their only view of interest was their cell phone screens. One of them lifted her head long enough to say, “Your dog is cute,” then returned to the rapture of her device. I thanked her and …

AI in medicine: Separate hype from reality

Kathryn Peper, MD

Health Technology

May 1, 2019

As a physician trying to keep up with all the new information about artificial intelligence, I want to know how machine learning and deep learning are impacting medicine now and to separate the hype from reality. Here’s a look at some ways AI is being used successfully in health care and some ways it is not.

AI has been validated for use in interpreting medical scans, pathology slides, and reading electrocardiograms. …

Digital health and artificial intelligence provide solutions to the global crisis in surgical care

Anonymous

Health Technology

May 1, 2019

In many countries around the world, women giving birth still face substantial risks to their own lives and that of their baby. Women travel for days to reach facilities that are understaffed, unsafe, and unequipped to provide life-saving surgical care. They are pushed into financial catastrophe as a result of paying for surgical care, if they are able to afford it all, and they return home with little support in …

Telehealth education: What do we actually need for our clinical practice?

Aditi U. Joshi, MD

Health Technology

April 30, 2019

As we go through our careers, we are given the responsibility of educating the next generation of students and residents to become proficient and competent in medicine. In telehealth, which also requires training my colleagues, is it necessary? If so, what should be part of it? Part of the equivocation with this question of creating telehealth education is at the core of the practice: since I strongly stress that telehealth …

Why virtual visits may be an important tool for your practice

Stuart Akerman, MD

Health Technology

April 27, 2019

Telemedicine has been available now for a number of years. Despite being widely accessible, it still struggles to maintain a foothold in the minds of many traditional practitioners. There are many reasons for this, including gaps in knowledge related to billing and reimbursement for virtual visits, as well as varying levels of coverage by insurance providers. This is particularly cumbersome when it comes to Medicare patients, although there is hope …

Death by 1,000 clicks: Where electronic health records went wrong

Fred Schulte and Erika Fry

Health Technology

April 22, 2019

The pain radiated from the top of Annette Monachelli’s head, and it got worse when she changed positions. It didn’t feel like her usual migraine. The 47-year-old Vermont attorney turned innkeeper visited her local doctor at the Stowe Family Practice twice about the problem in late November 2012, but got little relief.

Two months later, Monachelli was dead of a brain aneurysm, a condition that, despite the symptoms and the appointments, …

Telemedicine and access: Leave no patient behind

Aditi U. Joshi, MD

Health Technology

April 15, 2019

Telehealth, using video to have an acute medical care visit, puts some of the power of choice back into our patient’s hands. To best frame telehealth and its use cases, the National Quality Forum published a report in 2017, outlining the following four buckets which I find especially useful with evaluating programs and interventions:

access
cost savings
effectiveness
experience

This post is specifically about access and telehealth. I’m an emergency physician …

Could patients be their own scribes?

Efficient MD

Health Technology

April 11, 2019

One day while on shift in the emergency department, I looked out into the waiting room at the dozens of people waiting to be seen. Many had been waiting for hours. Some looked bored. Others appeared agitated by the long wait time. One thing that nearly all of them had in common, though, was the presence of a smartphone within arms reach. I wondered, rather than spending their time mindlessly …

Read more…

Could patients be their own scribes?

Carefully consider every aspect of the integration of AI into health care

Ton La, Jr., MD, JD

Health Technology

March 23, 2019

AI, artificial intelligence, is all the rage right now in medical news media. And this has many practicing physicians, even medical students, concerned. Will AI make diagnose heavy specialties such as dermatology and radiology obsolete? Can AI give rise to new medical specialties? How many tasks traditionally done by doctors will now be handled by AI?

I believe that there is a right to be worried. We do not have any …

Knowing how artificial intelligence works empowers clinicians to be at the forefront of using it

Kathryn Peper, MD

Health Technology

March 22, 2019

Physicians and other health care professionals are uniquely suited to understand artificial intelligence. They’ve studied or routinely use mathematics, data analysis, and algorithms. They comprehend pattern recognition, decision trees, rules-based systems, and statistics. These are the very components of AI. Perhaps the only thing our premed and medical training didn’t teach us was how to code. But we understand how coding is done. Add to this our training in how …

Will blockchain become the coin of the medical realm?

Michael Kirsch, MD

Health Technology

March 18, 2019

First, there was Bitcoin, a cryptocurrency that utilizes blockchain, a decentralized system of data collection and transactions that we are told will defy hacking. (Wasn’t the Titanic said to be unsinkable?) We read that cryptocurrency and other blockchain functions will be a societal gamechanger, much like the internet was when Al Gore invented it some years ago.

My state of Ohio will now accept Bitcoin as payment for commercial taxes.

And, of …

Understanding 6 trends shaping health care through gastroenterology

Praveen Suthrum

Health Technology

March 15, 2019

If you throw a pebble today, it’s likely to land on an article that talks about how artificial intelligence and its brother — machine learning — are changing health care.

Yes, I get it broadly. But I was curious to explore how exactly health care’s trends are shaping a single medical specialty. I chose gastroenterology (GI) because I’m most familiar with the space. And here’s what I found.

Trend #1: Manipulating bacteria …

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