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.

Creating a truly meaningful and useful patient medical record

Rob Lamberts, MD

Health Technology

September 26, 2013

I have a vague recollection, a memory shrouded in mist, where I pondered what seemed like a radical question: What would a health record look like if my only concern was patient care? This was a radical question because in my previous life I was an electronic health record aficionado. I was good at EMR, which meant that I was really good at finding work-arounds:

How can I work around the requirements for …
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Creating a truly meaningful and useful patient medical record

Addressing the disparities in those using patient portals

Zackary Berger, MD, PhD

Health Technology

September 24, 2013

My institution recently switched from its home-grown electronic medical record (EMR) to EPIC, a system for which many great things have been promised. Indeed, it is a considerable improvement over the past one. A number of hopes have been pinned on the latest-generation EMRs, not the least of which is the idea that finally, with this newest generation of tools, a nexus can be created and sustained among comparative effectiveness …

The hidden cost of free EMR systems

Elizabeth Hipp

Health Technology

September 21, 2013

Electronic health records (EHR) systems are expensive. Really expensive. In fact, there have been reports of these systems causing significant revenue decreases or business interruptions — such as Henry Ford Health System in Michigan reporting that implementing EPIC was a direct cause of their 15 percent net income decline in 2012. Using a free EHR system is a tempting alternative for many independent doctors or small practices. But are there …

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The hidden cost of free EMR systems

Does electronic communication actually improve care?

Natalie Azar, MD

Health Technology

September 18, 2013

The subject heading of a recent email correspondence read “beware, graphic picture ahead!” Obviously this piqued my curiosity, so, with one eye closed, I scrolled down on my iPhone to a picture of my patient’s tongue, which, truth be told, had a certain “you haven’t seen anything yet quality.”

The tongue in question? Maybe some white spots, certainly nothing gruesome, and most assuredly nothing I hadn’t seen before in my 12+ …

Better patient care doesn’t require more mouse clicks

Fred N. Pelzman, MD

Health Technology

September 15, 2013

Here are just a few of the mouse clicks, key strokes, and computer screens I need to make or navigate to get through my day: Control-Alt-Delete. User Name. Password. Double click on the icon to load the electronic health record (EHR). User Name again. Password again. Schedule. In-basket. Results. Patient Calls. Rx Requests.

And that is just to get started. Before I finish my first cup of coffee.

Every patient interaction that needs …

Google Glass for medicine: 4 reasons why it could be disastrous

Matthew Katz, MD

Health Technology

September 14, 2013

google glass

The buzz is that Google Glass will transform medicine. But unless it’s carefully vetted it could be a disaster for patients, clinicians and hospitals. Until the FDA or research confirms its safety, Google Glass is banned from my clinic as a privacy and medical practice hazard.

Here are four reasons why:

1. Privacy violations. Google Glass make it extremely easy to take pictures or …

E-health initiatives that focus on patients can improve outcomes

Donald Tex Bryant

Health Technology

September 14, 2013

Health care providers want their patients to have the best outcomes possible. They know that for this to happen that the patient must be engaged in managing his or her condition, whether it is an acute or chronic condition. Patients need to follow the provider’s directions and orders. If they do not, then the outcomes will be sub-par.

For instance, if you the provider give a patient a prescription then they …

We need tools to meaningfully interpret health data

Peter Alperin, MD

Health Technology

September 11, 2013

We generate it every minute of every day of every week of every month of every year. Data, in countless forms. Of recent and growing interest to a great many people is how this data can be use to improve health (not just sell people more stuff).

Wear a FitBit or Jawbone? Amazing source of activity information. Check in on Foursquare? Insight into dietary habits. Post on Twitter? Sentiment analysis around …

A doctor creates his own EMR out of pure survival

Rob Lamberts, MD

Health Technology

September 9, 2013

The question has been raised: Why re-invent the EMR wheel? What is so different about what I am doing that makes it necessary to go through such a painful venture? I ask myself this same question, actually.

Here’s my answer to that question.

What medical records offer:
High focus on capturing billing codes so physicians can be paid maximum for the minimum amount of work.

What I need:
No focus on billing codes, instead a …

Health care through the lens of a technology entrepreneur

Davis Liu, MD

Health Technology

September 4, 2013

If you want to see the future of health care, the can’t miss conference of the year is the Health Innovation Summit hosted by Rock Health in San Francisco. As a practicing primary care doctor, I had the opportunity to view health care through the lenses of technology entrepreneurs. I thought the conference was even better than the one I attended last year. Absent was the provocative rhetoric by 2012 …

Your EMR is watching you

Skeptical Scalpel, MD

Health Technology

September 2, 2013

A recent article on American Medical News titled “Medical charting errors can drive patient liability suits” led with a case involving a bad outcome after coronary artery bypass surgery. The plaintiff’s attorney alleged that the doctors did not review the patient’s lab results or x-rays because they did not specific say so in the medical record.

The article quoted a defense attorney who said, “By the time [the doctors] are deposed, …

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Your EMR is watching you

The sad state of EMRs: How they are doing more harm than good

Val Jones, MD

Health Technology

August 30, 2013

I used to be a big believer in the transformative power of digital data in medicine. In fact, I devoted the past decade of my life to assisting the “movement” towards better record keeping and shared data. It seemed intuitive that breaking down the information silos in healthcare would be the first logical step in establishing price transparency, promoting evidence-based practices, and empowering patients to become more engaged in their …

The mixed blessing of health information technology

James Marroquin, MD

Health Technology

August 25, 2013

The recent revelation of the NSA’s top-secret mass surveillance program by Edward Snowden has spotlighted the benefits and burdens of our increasingly digitally connected world. According to President Obama, monitoring our phone calls, emails, and web activity has helped thwart dozens of terrorist attacks. But the idea of the government keeping track of what had hitherto seemed private raises the specter of an Orwellian world in which everyone is under …

The challenge of using health IT more effectively

Ashish Jha, MD, MPH

Health Technology

August 21, 2013

Just a little over four years ago, President Obama, in his inaugural address, challenged us a nation to “wield technology’s wonders to raise health care’s quality and lower its costs.” This was an awe-inspiring, “we will go to the moon” moment for the healthcare delivery system. But the next thought that ran through the minds of so many of us who work on health IT issues was this: how were we …

5 ways Google Glass can be used in a hospital

John Halamka, MD

Health Technology

August 20, 2013

I recently had the opportunity to test Google Glass.

It’s basically an Android smartphone (without the cellular transmitter) capable of running Android apps, built into a pair of glasses. The small prism “screen” displays video at half HD resolution. The sound features use bone conduction, so only the wearer can hear audio output. It has a motion sensitive accelerometer for gestural commands. …

7 golden rules to optimize EHR implementation

Rosemarie Nelson

Health Technology

August 18, 2013

Eligible physicians are dropping out of the HITECH incentive program. Why? Often, it’s because a practice implements an EHR and then tries to mimic all their old paper processes and workflows.

That can get them through the vendor’s initial implementation, but it is not sustainable for the long term.

Workflows and operational processes must be modified to optimize the new tool. Technology changes what is feasible, and to adapt, we need to …

Why EMRs will not placate technology-hungry medical students

Maureen Miller, MD, MPH

Health Technology

August 17, 2013

The first resident who really reamed me out on the wards was having trouble reading my handwriting. My handwriting became doctor-unreadable well before medical school, but how quaint. It was the beginning of my second month of clinical training, and hers of internship. She couldn’t follow our shared patient’s daily progress note. I didn’t tell the story in the right order. The format was wrong. Instead of noting only pertinent …

Fix Google Maps before patients start dying

Chris Boyer

Health Technology

August 15, 2013

It happened to me again.

This morning I got another email from one of our physician practices:

“Our early morning patient was late today because she Googled our office and it gave her the wrong directions/location. Help!”

This is not a one-time thing. Over the last seven months that I’ve been in my new position (and the four years prior at my old position), I …

Does home monitoring make a difference in cost and outcomes?

Kevin R. Campbell, MD

Health Technology

August 15, 2013

Technology in medicine advances at a rapid pace. In the US today most patients have access to mobile phones, smartphones and tablets. Medical device makers continue to innovate and create ways in which these technologies can be used by patients and physicians to monitor complex biologic machinery such as implantable cardiac defibrillators (ICDs) and pacemakers at home — without the need for …

How an iPhone improved patient care in the ICU

Iltifat Husain, MD

Health Technology

August 12, 2013

At iMedicalApps we have traditionally expounded on how smart phones can help us with patient care in regards to providing Physician centric tools at bedside. These range from drug reference tools to various clinical algorithm medical apps.

But there are also non-traditional methods where smartphones enable us to improve patient care at the bedside. These are subtle, but can be equally or more powerful.

When I was working in the ICU recently, there were …