For the record: I am a geek. I love technology. I adopted EMR when all the cool kids were using paper. Instead of loitering in the “in” doctors lounge making eyes at the nurses, I was writing clinical content and making my care more efficient. I was getting “meaningful use” out of my EMR even when nobody paid me to do it.
But …
Only one company can deliver the perfect EMR: Google
Today I’m doing anesthesia for colonoscopies and upper GI scopes. Nowadays we have three board-certified anesthesiologists doing anesthesia for GI procedures every single day at my institution. I’ll probably do 8 cases today. I will sign into a computer or electronically sign something 32 times. I have to type my user name and password into 3 different systems 24 times.
I’m doing essentially …
10 ways to make EMRs more doctor-friendly
Somewhere between the 20th century bank ATM and the 25th century Tricorder, lays the EMR that we should have today. Somewhere between the government-designed meaningful use EMR and the holographic doctor in Star Trek, there should be a long stretch of disposable trial-and-error cycles of technology, changing and morphing from good to better to magical. For this to happen, we must release the EMR from its balls and chains.
We must …
EMRs cannot fix the financial and physical health of the nation
The electronic medical record (EMR)’s promised contribution to health care cost savings got a second look recently, and the results were poor at best. But what I found interesting was the “second look” was from the same organization that did the first look: the corporately-funded, non-profit think-tank called the RAND Corporation.
From their second and more recent report:
A team of RAND Corporation researchers projected in 2005 that rapid …
When EMR interactions trump patient care
Right now, the technology exists to completely transform healthcare.
A doctor should be able to walk into the room where a patient is waiting for them and get everything they need to make an informed decision about that patient’s care.
Location-based technology should sense the doctor approaching and already know which patient is waiting for them. A computer or a tablet in the room should have access to thousands of data points …
Technology is being held back from transforming healthcare
There are an estimated 15,000 medical apps presently on the market and is expected to grow 25% per year according to one study. There are issues which are common in the development of these apps and other categories of apps. However, some technical and non-technical issues are unique to the sector. As someone who does not design apps, …
5 reasons why mobile health apps fail
I recently read an article on the RAND Corporation’s analysis of electronic health records (EHRs). As a practicing pediatrician currently using EHRs, and given the reality that EHRs are still a relatively new addition to the U.S. medical profession and have created a fundamental shift to the care delivery process, I am compelled to respond to assertions made in this article.
The first RAND study, sponsored by a …
Refuting RAND: Why I am optimistic about EHRs
Office-based medical practice is changing fast. The government is providing incentives to those practices that use electronic prescribing and electronic records systems and will soon penalize those that don’t. Health reform will shortly deliver many newly insured patients to your office. A host of new patient care models aimed at making healthcare more team-based are emerging. Reimbursement tied to outcomes will demand a greater level of patient management and engagement …
Your EHR needs a population health management system
The X-Files fans will remember the poster that Agent Mulder had on his bulletin board with a picture of a flying saucer and the words, “I want to believe.” That’s how I feel reading EMR notes sometimes. I want to believe, but I doubt.
I know how this happens. The EMR vendor, the practice implementation team and the doctor have a meeting to develop the “normal” template for a hospital admission …
The EMR template: I want to believe
I recently sat in a small room, in the bowels of a local hospital, training for the impending implementation of CPOE. For those not familiar with current health care acronyms, this stand for Computerized Physician Order Entry.
Nearing the end of my medical career, I could not help but admire the timing of this phenomenon. “They’ve finally done it,” I mused silently. They …
How the physician replaced the medical secretary
Health information technology (HIT) has had a tremendous – and mostly positive — impact on our systems for recording, delivering, monitoring, and reporting the healthcare and services we deliver.
Like most of my colleagues, I can tick off at least five or six large “pioneer” corporations – companies like Epic, Cerner, Allscripts, Siemens – in the forefront of the technology explosion that yielded …
Doctors lack an analytic engine: Why we need EMR 3.0
For practicing physicians, there’s a tricky balance in believing that the Internet can help save lives.
I’m a doctor who encourages families to look up health info online and one who believes technology will afford improved partnerships. Yet, when we’re in the old-fashioned exam room, there isn’t always a place for the Internet. Many clinics block video-streaming sites and don’t allow for traditional email …
Dr. Google: Tips for patients who diagnose online
I have long been a proponent of proven technology in the digital health space. Probably the most obvious reason is to dispel the generalized notion that these technologies are flimsy. The HHS Text4HealthTask Force has endorsed clinical studies in its recommendations. There certainly have been studies performed. One interesting one, the final report of The National Mobile Health Worker Project of the …
5 reasons why mobile technology needs clinical trials
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The implementation of the electronic medical record (EMR) in American medicine gained a powerful foothold in medical care with the passage of the American Reinvestment and Recovery Act (ARRA) in 2009. With the passage of this act came the promise of improved efficiencies, safety and ultimately reduced cost delivery for health care. Also, some $18 billion dollars in financial incentives were offered to physicians …
The ethics of EMR: How unproven technology affects patients
Should physicians use a consultant to help choose a practice management system or EHR for their practice? According to recent Medical Group Management Association surveys more than 50% of physicians used the services of a healthcare consultant or firm at least once in the previous 3 years.
But did they have to? Was it a smart move?
The answer: It depends
Not every practice needs a consultant’s assistance when replacing and choosing …
When should physicians hire an IT consultant?
On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. So why the Mini? What is …
Using the iPad Mini in the hospital: One doctor’s experience
Wikipedia defines patient portals as “… healthcare-related online applications that allow patients to interact and communicate with their healthcare providers. Some patient portal applications exist as stand-alone websites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of a healthcare provider. Still others are modules added onto an existing electronic medical record system. What all of these services …
Do patient portals increase patient engagement?
When I completed my internal medicine residency, my fellow trainees knew I was headed for a rural practice in Vermont. Much to my surprise, they gave me a traditional doctor’s black bag – a beautiful leather bag with pockets inside for instruments, tongue depressors, syringes, prescription pads, and all my tools. It was an extraordinarily meaningful gift that acknowledged a launch …
2 ways technology will improve patient care
Happy New Year! It’s 2013! Time for us to embark on ambitious health and fitness resolutions we have no intention of keeping past March!
Here to assist us with our resolutions are a collection of fitness devices and apps that will help track our heart rate, sleep cycles, calories burned, steps walked, mood and much more. Data from these devices can …
Patients who self track their data: Curb your enthusiasm
”Email is the killer app of patient portals.”
I heard a variation of that quote when interviewing people for the patient-provider communication chapter of the book I’ve been co-editing and writing for HIMSS with Jan Oldenburg, Brad Tritle and Kate Christensen. For the organizations who’ve pushed patient portals the furthest into their patient base, email is always the place where things started. In other words, email is the gateway drug for …
How secure messaging and email benefit patients and improve outcomes
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