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.

Why it’s risky to pay for a proprietary health IT system

Edmund Billings, MD

Health Technology

May 10, 2013

“No aspect of health IT entails as much uncertainty as the magnitude of its potential benefits.”

A few years into the Meaningful Use program, it seems this quote from a 2008 Congressional Budget Office report entitled “Evidence on the Costs and Benefits of Health Information Technology” may have been written with the assistance of a crystal ball.

Fast forward to 2013.

“Just from reading a week’s worth of news, …

The advantages of having a connected EHR

Donald Tex Bryant

Health Technology

May 10, 2013

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Most clinical providers are aware of the more common capacities of EHRs. However, there are many capacities that are being underused that can be of great assistance in providing safe care that avoids waste and identifies best practices. Electronic communication with providers outside of one’s clinical setting, clinical decision support and improving the body of knowledge of best practices are three of …

5 critical elements of patient-centric care

David Lee Scher, MD

Health Technology

May 7, 2013

I would like now to delve into what I consider critical elements of patient-centric care. They all involve technology to various extents.

1. There must be buy-in from providers. I am including payers, healthcare systems as well as clinical providers in this category. While I realize that much of healthcare is devoted to satisfying legal and regulatory mandates, there is great opportunity to improve the care experience (and dare I say …

Thoughtful recommendations of health apps

Leslie Kernisan, MD, MPH

Health Technology

May 6, 2013

If I were asked “Why should a clinician prescribe an app?” I would answer as follows:

Because it’s likely to help the patient reach his or her most important health goals, and is a good fit within an over-arching medical management plan.

In other words, if the goal is to provide sensible medical assistance to patients and families, the use of an app should be likely to:

Help a patient work towards the …
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Thoughtful recommendations of health apps

A plea for a universal, unified EMR

James C. Salwitz, MD

Health Technology

April 29, 2013

At some point, this gets to be ridiculous. Online, I can buy any item from anywhere at any price, pay any bill, watch any movie, listen to any song, order dinner, schedule car repair or read about any subject on Wikipedia. I can determine the weather in Rio, sport scores of Barcelona, Parisian traffic or by GPS the location of my kids, just down the block.

However, I absolutely cannot learn …

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A plea for a universal, unified EMR

The role of remote patient monitoring in mobile health

David Lee Scher, MD

Health Technology

April 21, 2013

As defined in Wikipedia, remote patient monitoring (RPM) is: “a technology to enable monitoring of patients outside of conventional clinical settings (e.g. in the home), which may increase access to care and decrease healthcare delivery costs.”

I was a pioneer adopter of RPM as a beta site for Medtronic’s Carelink wireless system which monitors implantable cardiac rhythm devices (defibrillators and pacemakers). RPM has gained significant attention because of recently mandated penalties …

How natural language processing can help EHRs

Phil Simon

Health Technology

April 21, 2013

An excerpt from Too Big to Ignore: The Business Case for Big Data (Wiley and SAS Business Series).

Unstructured and semi-structured data is, by its nature, largely text based. Even numbers are often surrounded by words, like an article on a company’s stock. This section describes some of the tools that translate what is often a bunch of gobbledygook into meaningful information, the result of …

Let’s mourn the death an EMR evangelist

Rob Lamberts, MD

Health Technology

April 19, 2013

It feels like part of me is dying. I am losing something that has been a part of me for nearly 20 years.

I bought in to the idea of electronic records in the early 90′s and was enthusiastic enough to implement in my practice in 1996. My initial motivation was selfish: I am not an organized person by nature (distractible, in case you forgot), and computers do much of the …

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Let’s mourn the death an EMR evangelist

EMR designers: Your actions can kill

Jordan Grumet, MD

Health Technology

April 19, 2013

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The ICU hummed as the tech guy waltzed in at two in the morning. A key designer of the EMR himself, the night shift nurses had his mobile and were not afraid to use it. There was a problem reconciling Mr. Jones med list after his emergency bypass surgery that evening. Patients first.

The next one in the door was the young CEO …

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EMR designers: Your actions can kill

EMR tips for locum tenens doctors

Edwin Leap, MD

Health Technology

April 19, 2013

If I’m learning anything from working locum tenens jobs, it’s that there is a wide, mind-numbing variety of electronic medical records (EMR) systems in place around the country. At my primary work site, we use Med-Host. Like every EMR, it has some bugs. But having seen other systems in other places, it’s clearly a Cadillac product in a great, big car lot of Yugos.

I’m not going to disparage other systems …

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EMR tips for locum tenens doctors

Prevent physician burnout with these 2 mobile apps

Dike Drummond, MD

Health Technology

April 15, 2013

Forget Angry Birds and other mobile apps that do a great job of helping you waste time. And set aside for now the apps that help you find information and practice clinical medicine more efficiently. It was only a matter of time before mobile apps would be developed that can actually help you prevent physician burnout.

Here are my two favorite free mobile apps to help you lower stress and create …

If you build a patient portal, why won’t they come?

Steve Wilkins, MPH

Health Technology

April 13, 2013

I hate saying I told you so. But “patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.”

Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS 2013.

The headline: “Mayo Clinic struggles to meet stage 2 meaningful use thresholds for engaging patients.”

Always innovating, the Mayo Clinic some three years ago introduced a web-based portal to share information with …

The New York Times gets it wrong on health IT

Robert Wachter, MD

Health Technology

April 11, 2013

I’m well aware that a good fraction of the people in this country spend their lives furious at the New York Times. I am not one of them. I love the Grey Lady; it would be high on my list of things to bring to a desert island. But every now and then, the paper screws up, and it did so in a big way in its …

Medical apps: We are approaching the tipping point

Joe Flower

Health Technology

April 7, 2013

The progeny of the iPhone and the iPad will change the shape of your institution — and your balance sheet.

One of the more striking images, to me, out of the online spew in the last few months was from the inauguration. It was a wide view of an inaugural ball. There was the president waltzing with the first lady, and a crowd of several hundred watching them. What was striking …

What patients want from mobile apps

Jessie Gruman, PhD

Health Technology

April 4, 2013

Dear mobile health app developers,

We—patients and caregivers—need your help to reduce the demands of self care. Mobile health (mHealth) apps have enormous potential to lessen our burdens. But our needs are often only loosely related to what clinicians and/or the evidence expect us to do. Most mobile app developers have ignored this fact by designing tools that primarily reflect the imperatives of …

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What patients want from mobile apps

Questions to ask when considering new medical technology

Leslie Kernisan, MD, MPH

Health Technology

April 2, 2013

“Hey doctor, what do you think about this product/solution/service?”

These days, I look at a lot of websites describing some kind of product or solution related to the healthcare of older adults. Sometimes it’s because I have a clinical problem I’m trying to solve. (Can any of these sleep gadgets provide data — sleep latency, nighttime awakenings, total sleep time — on my elderly patient’s sleep complaints?)

In other cases, it’s because …

IBM’s Watson starts its medical career

Margalit Gur-Arie

Health Technology

March 30, 2013

IBM’s Dr. Watson of Jeopardy! fame has finally completed its residency and fellowships and, presumably to its creators’ utter delight, is now a practicing oncologist.

The prodigy “cognitive system” completed its training in less than a year at the illustrious Memorial Sloan-Kettering Cancer Center, and although only proficient in lung cancer right now, Dr. Watson’s career as an advisor to oncologists …

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IBM’s Watson starts its medical career

Our most scarce health resources are asked to carry the largest load

Jordan Grumet, MD

Health Technology

March 26, 2013

It happened, of all times, when I was in the car driving the kids to violin practice. My pager buzzed with a message from one of the medical floors. I waited till the car was parked, and dutifully pecked the numbers on my cell phone.

Hello doctor, we have your patient, can you please put admitting orders into EPIC?

I, of course, like most doctors, wasn’t sitting by my phone waiting at a computer terminal. …

Will CommonWell solve one of the biggest problems in health IT?

Adrian Gropper, MD

Health Technology

March 23, 2013

The big news at HIMSS13 was the unveiling of CommonWell (Cerner, McKesson, Allscripts, athenahealth, Greenway and RelayHealth) to “get the ball rolling” on data exchange across disparate technologies. The shame is that another program with opaque governance by the largest incumbents in health IT is being passed off as progress. The missed opportunity is to answer the call for patient engagement and the frustrations of physicians with EHRs …

Why digital health tools need to be rated

Thomas Santo, MD

Health Technology

March 23, 2013

The digital health revolution is in full swing, and there are an abundance of new mobile and web-based digital health tools that address everything from nutrition and exercise habits to disease-specific conditions and hospitalization. Consumers have embraced the new trend, and are becoming more actively involved in tracking and managing their own health.

This is an incredibly important paradigm shift on the oft-ignored side of the health care equation: the patient. …