A couple of weeks ago I took my car in for its regular servicing. I’ve always had excellent service at this dealership and have gotten used to some pretty high standards. But on this particular visit, I was about to receive a dose of new technology as well. After I pulled my car into the garage, I was immediately greeted by a welcoming and friendly customer service agent. She had …
Car dealerships have something to teach hospitals
As I look back all those years ago to when I chose medicine as a career, I suspect that my motives were similar to most people who enter this wonderful profession. I wanted to become a doctor because I had a genuine and sincere desire to help people. I also liked the idea of a busy and energetic job, one where I was comfortably as far away as possible from …
The human side of medicine that no computer can ever touch
I know what you’re thinking, punk. You’re thinking “did he fire six shots or only five?” Now to tell you the truth I forgot myself in all this excitement. But being this is a .44 Magnum, the most powerful handgun in the world and will blow you head clean off, you’ve gotta ask yourself a question: “Do I feel lucky?” Well, do ya, punk?
– Harry Callahan (played by Clint …
Who do you want reading your EKG?
In every strength lies a weakness and in every weakness a strength. This maxim has held true throughout history — from biblical days to the battles of modern times.
And it holds just as true in the information technology (IT) “arms race” that’s playing out in American health care today.
In Malcolm Gladwell’s newest work David and Goliath, he suggests that when we fail to …
Watson and Siri: The David and Goliath in health care delivery
Consider this scenario. Your clunker is on its last legs, and it’s time to get a new car. Most likely, you’ll search product reviews to help you decide which make and model is best — best according to people who’ve driven them and kicked the tires a bit, not based on company accolades. You’ll want to know what drivers think. Amazon.com does the same thing for books (and every other …
Keep your government hands off my EHR
I was invited to attend a private breakfast with book author, surgeon, and New Yorker contributor Dr. Atul Gawande shortly before Dr. Gawande’s talk at The New Yorker Festival. Over breakfast, Dr. Gawande spoke with IBM executive Dr. Paul Grundy on the future of health care. The event was sponsored by IBM so there was plenty of talk about how technology can and will influence the practice of medicine — …
Can technology be a change agent for health care?
I have been following the news about the National Security Agency (NSA) access to our phone records with great interest. If we as a society don’t sort some of this out, we’ll see a repeat in the health sector a few years from now.
These discussions seem to pivot on issues of population-level safety vs. personal liberty, and on trust vs. suspicion re: how much of the process is driven by …
Why our personal health data will become less private
A recent article by Elizabeth Hipp decried the so-called hidden costs of free EMR systems.
As a physician who uses a free EHR, I chuckle at stories trying to drum up fear and uncertainty about these systems. Though free EHRs have become mainstream, there still seems to be a clever news angle in highlighting their supposed pitfalls. We live in a time when Google offers all of its services …
The benefits of a free, web based EHR
About eight years ago I was desperate to improve my golf game. I just couldn’t straighten out my drives or hit my irons crisply. (Yes, I’m fully aware that this is a first world problem). I decided to try golf camp in Palm Springs for a few days.
My sensei, a crusty ex-touring pro named Artie McNickle, watched me hit several dozen balls on the driving range, video recorder running. “So, …
How video can reduce medical errors and improve patient care
Trust: A firm belief in the reliability, truth, ability, or strength of someone or something.
Technology, technology, technology.
It is all we hear.
Ugh.
Let’s change the focus from “technology” to the useful and meaningful processes that technology enables:
Technology is only an enabler, much like the social graph. They are tools, they are platforms, and if properly utilized, they may enable “disruption” or transformation. It is the few individuals, and I do mean a few, …
Use technology to build trust with your patients
A recent experience with my father-in-law reminded me of something that has concerned me for some time. While EMRs have some benefits for older adults, on balance I believe that they portend more dangers. There are multiple reasons, but the biggest is that health care providers tend to believe everything they read in an EMR. Even if what they read is wrong!
A wise computer programmer once told me that “computer’s …
Why electronic medical records are dangerous to older adults
The hype over mobile health is deafening on most days and downright annoying on some. So it is with some reluctance that I admit that mobile has the potential to be a gamechanger in health. I’ve professed enthusiasm before, but that was largely around the use of wireless sensors to measure physiologic signals and SMS text as a way to deliver messages to patients and consumers. For several years, the …
Patient care appears to be catching up with mobile technology
Over the next few months, Jacob Reider will serve as the interim National Coordinator for Health Information Technology (ONC) while the search continues for Farzad Mostashari’s permanent replacement.
What advice would I give to the next national coordinator?
David Blumenthal led the ONC during a period of remarkable regulatory change and expanding budgets. He was the right person for the “regulatory era.”
Farzad Mostashari led ONC during a period of implementation when resources peaked, grants were …
Advice to the next national coordinator for health IT
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I assume by now that you’ve heard the news: Google wants to tackle aging. Specifically, they announced the launch of Calico, “a new company that will focus on health and well-being, in particular the challenge of aging and associated diseases.”
Because, says Larry Page, with some “moonshot thinking around healthcare and biotechnology, I believe we can improve millions of lives.”
“Can Google Solve DEATH?” shrieks a TIME cover.
Google’s goal, it seems …
We need more innovations in caring, not curing
Health IT is booming, or so they say. The hotly debated and highly politicized health care reform, a.k.a. Obamacare, has been shining bright lights on a segment of our economy that is quickly approaching $3 trillion per year, and is in dire need of improvement, or so they say. Depending on who you ask, some say that health care resources must be redistributed in a more equitable manner, while others …
Health IT will dictate how health is provided in the future
Recently there’s been a lot of talk about the law of bundling and subsequent unbundling of web services. Many have used Andrew Parker’s brilliant image below to make the point.
Craigslist came along and bundled everything into one place and, as a result, completely dominated. They destroyed multiple businesses in the process (including the rental and roommate web service I worked with …
What the unbundling of Craigslist has to do with today’s EMRs
I recently supervised a new intern as she conducted a patient interview. Following procedure, the intern reviewed the patient’s electronic medical record (EMR) and checked his lab results. She noticed that his cholesterol was high, and he told her that he had stopped taking his atorvastatin due to a recent trip to the Dominican Republic.
“It’s no problem,” my intern replied. “We’ll get you back on the medication.” She began to …
Fighting the patient-computer attention war
EMRs are not designed for patient care. Is there anyone working in health IT who can honestly say that he or she never heard this statement being made hundreds or thousands of times? Is there any clinician actually working with patients and EMRs who can state that such thought never crossed his or her mind? This includes health IT evangelists and physicians spearheading IT initiatives at the most excellent of …
Why physicians will never learn to like EMRs
There was a memorable scene in the movie “The Graduate” from 1967. You may know it or have heard of it, when the older man turns to the college graduate and says the future is all about one word: “plastics.”
Well, plastics may have been then, but this is now. And the core themes I keep hearing these days there are two central …
The promise and the peril of big data in health care
The medical board of the state of Oklahoma recently sanctioned a physician for using Skype to conduct patient visits. A number of other factors add color to the board’s action, including that the physician was prescribing controlled substances as a result of these visits and that one of his patients died. This situation brings up several challenges of telehealth — that is, using technology to care for patients when doctor …
Using Skype for patient visits: A doctor is sanctioned
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