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.

Technology in health care: Is medicine really evolving?

Health Technology
April 20, 2016

Evolution is part of life, something we accept as a fact and evidenced by the changes we see and know compared to hundreds of years ago. No one can dispute the great technological advances that have been made; transport has been revolutionized from the animal power of horse and cart to the mechanized systems of train, plane and automobile we have today.

Communication systems once reliant upon the written word and …

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Technology in health care: Is medicine really evolving?

Connected health: It’s time to write a different headline

Health Technology
April 16, 2016

We live in a headline/hyperlinked world.  A couple of years back, I learned through happenstance that my most popular blog posts all had catchy titles.  I’m pretty confident that people who read my blog do more than scan the titles, but there is so much information coming at us these days, it’s often difficult to get much beyond the headline.  Another phenomenon of information overload is that we naturally apply heuristics or …

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Connected health: It’s time to write a different headline

Physicians and patients must retake control of how health care is delivered

Health Technology
April 13, 2016

For years, many physicians have complained about the onerous nature of government-certified electronic medical records. However, thanks to the HITECH Act, the rush to digitize medical records has continued. Due to the impetus provided by the ACA and subsequently by MACRA, the mad rush has progressed into a frenzy of data-collecting and reporting activity, all in the name of value over volume.

Recently, two objective reports have surfaced demonstrating the futility of …

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Physicians and patients must retake control of how health care is delivered

Working with today’s EMRs is mentally exhausting

Health Technology
April 5, 2016

I was at a locums assignment yesterday using FEEMRS. (You know, “Fancy Expensive Electronic Medical Records System.”) It was all kinds of busy, with wait times of many hours. And as I slogged along, relearning FEEMRS after a few weeks away, I realized that it takes about one hour of looking at that screen for me to become exhausted.

It’s just too busy. Every bit of the screen seems filled with …

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Working with today’s EMRs is mentally exhausting

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

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

Meaningful use creates meaningless strife

Health Technology
March 23, 2016

One of the biggest topics today in the health care field is that of meaningful use.  Meaningful use is defined as using certified electronic health record (EHR) technology to improve quality, safety, efficiency, and reduce health disparities.  The promise is that meaningful use will help improve patient and provider communication and increase care coordination while maintaining the privacy and confidentiality of patients.

However, serious questions are emerging about whether this is …

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Meaningful use creates meaningless strife

EMRs displaces medicine’s art. Here’s why that matters.

Health Technology
March 10, 2016

I know a wise old forester. Ask him any question and he’ll answer, “Well, now, it depends on what you want.”

“Should we clear this underbrush or just leave it?” It depends on what you want.

I realize this can explain any choice we’ve made: that is, we have what we have because, at some level, that’s what we want. In that light, let me discuss electronic medical records.

EMRs can be wonderfully …

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EMRs displaces medicine’s art. Here’s why that matters.

3 immediate ways health IT can improve

Health Technology
March 1, 2016

We’ve got a long way to go before information technology solutions at the frontlines of health care fulfill their enormous potential. The suboptimal, clunky and cumbersome design of most IT systems is responsible for much misery among physicians and nurses on a daily basis. Part of the problem is that hospitals and clinics have rolled out these solutions rapidly and somewhat haphazardly to fulfill meaningful use requirements and gain much-needed …

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3 immediate ways health IT can improve

These are the technologies that can help achieve the cancer moonshot

Health Technology
February 22, 2016

In his State of the Union address in 2016, President Obama pledged a new national effort to find a cure for cancer. This is the cancer “moonshot.” Last year, he announced the launch of the Precision Medicine Initiative — a bold new research effort to revolutionize how we improve health and treat disease. These two strategies together hold the promise of curing cancer or, at least, transforming it …

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These are the technologies that can help achieve the cancer moonshot

Health IT’s woes are a moral problem that needs to be solved

Health Technology
February 8, 2016

I was dining at a friend’s house recently after a long day in the hospital. He has just bought a beautiful new home with his rapidly expanding family, and like anyone who has just moved into a new house, his spare time is invariably spent working on getting everything in order and undertaking small upgrades to make the new place as perfect as possible.

He’s quite DIY-oriented (unlike myself) and was spending a lot of …

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Health IT’s woes are a moral problem that needs to be solved

We need to demand technology that lets doctors be doctors

Health Technology
February 1, 2016
YouTube video

A long time ago in a galaxy far, far away … what an uncannily accurate description of how it feels to practice in our very own “modern” health care system. In a world brimming over with exponential tech advances — supercomputer smartphones with user interfaces an embryo could master, an open Internet backbone that connects us across continents and cultures — our health care universe languishes with software that’s …

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We need to demand technology that lets doctors be doctors

What smartphone apps can learn from the humble pager

Health Technology
January 30, 2016

Despite high interest and hopes, the clinical adoption of new mobile technologies such as smartphone apps and wearables for health care has been modest.  While some clinicians and clinics are of course using the newest connected devices and apps, most would report they don’t regularly use mobile health technology yet. But they actually do. The vast majority of clinicians have been using mobile health technology for decades without even realizing …

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What smartphone apps can learn from the humble pager

Here’s why medical record have opinions

Health Technology
January 28, 2016

Software has opinions. No, I’m not talking about opinions on the next presidential election or opinions about flossing before or after brushing. Software has opinions about how data should be displayed, opinions about users’ comfort with the mouse, even, in some cases, opinions about what you should have for dinner (see your local on-demand food ordering service).

We tend to view software as a tool that is either good or bad. …

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Here’s why medical record have opinions

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Health care is about relationships. Health IT fails to understand that.

Health Technology
January 28, 2016

The promise that information technology holds for health care is, quite literally, amazing. So far, it has enabled us to get rid of paper charts (not to mention the age-old problem of illegible doctors’ handwriting), negated the need to trawl through mountains of files to find old clinical data, and introduced much-needed safety improvements such as medication alerts.

But anyone practicing at the frontlines of medicine over the last few years …

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Health care is about relationships. Health IT fails to understand that.

It shouldn’t be so hard for patients to correct their medical record

Health Technology
January 27, 2016

This past summer an article in USA Today talked about Regina Holliday’s efforts to make the medical record more easily and promptly available to patients, so it becomes as a tool patients use as they engage in co-managing their own care. Her cause is just, and her story is compelling, so I was dismayed at the pushback saying: Not so fast. There are lots of errors and ambiguities in the record, …

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It shouldn’t be so hard for patients to correct their medical record

An Uber for health care is closer than you think

Health Technology
January 21, 2016

Will there be an Uber for health care? Articles are split. The truth is there will be an Uber for health care. It just isn’t here yet. Expect it to be widely available in the next decade and as a result, people will get expert medical care that is more convenient, less expensive, and accessible.

What issues must an Uber for health care solve?

Media articles that have prematurely proclaimed that Uber …

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An Uber for health care is closer than you think

A 2016 wish list for health care IT

Health Technology
January 16, 2016

As the New Year arrives and health care continues its rapid evolution, one of the most critical challenges that we face is the interaction of information technology with frontline clinical medicine. If you were to ask, at the start of 2016, any physician (or even nurse) what their biggest daily frustrations are — most would list health care IT at or near top of the list. And it’s not just …

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A 2016 wish list for health care IT

Health IT needs to be seen but not heard

Health Technology
January 4, 2016

You may be forgiven after reading some of my articles for thinking that I’m somehow “anti-health care information technology.” It’s a subject that I’ve written a lot about over the last couple of years, mainly because I feel passionately that our use of information technology at the frontlines of health care needs to drastically improve.

But let me start first by making a confession: I love information technology. I am just …

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Health IT needs to be seen but not heard

How to put EHRs back on the right track

Health Technology
December 24, 2015

“It was a dark and stormy night.”

My computer didn’t catch fire while typing the previous sentence. No alarms were triggered warning me about the quality of such opening. I wasn’t prompted to select subjects and predicates from drop-down lists. I typed the entire sentence, letter by letter, not at all dissimilar to its first rendering back in 1830. Computer software, in general, and Microsoft Word in particular, magically removed the …

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How to put EHRs back on the right track

7 Christmas wishes for electronic medical records

Health Technology
December 23, 2015

Dear Santa,

I’ve been a very good doctor all year. I have checked all my boxes and aced all my meaningful use requirements. This year, I’m not asking you for anything fancy. I just thought you might be able to instill some kindness and good will into the people who designed the user interface of my EMR. Maybe, with your help, they would come to see how a few minor tweaks …

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7 Christmas wishes for electronic medical records

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