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.

Make IT vendors your partner for a smooth EMR transition

Rosemarie Nelson

Health Technology

November 10, 2012

Vendors talk about partnering with medical practices all the time – especially in the information technology (IT) world of electronic health records (EHRs) and practice management systems. But, ask any physician about their IT solution and most will express dissatisfaction, unhappiness, or harsh complaints.

The reason? For the most part, medical groups are not trained effectively for integrating IT into their work flow.

Ask EHR vendors about their approach to training and …

Misinformation in electronic medical records has consequences

Anna Lembke, MD

Health Technology

November 6, 2012

Electronic medical records have become an essential backdrop to modern medical practice. Paper charts, not long ago the mainstay of health-care documentation, have become antediluvian. Whereas once doctors used to write notes with pen and paper and insert the paper into a physical binder, doctors now keep track of patients by clicking keys on a keyboard and entering data into a computer software program.

One of the great advantages of the …

Stockholm syndrome and Epic’s takeover of medical records

Paul Levy

Health Technology

November 5, 2012

Stockholm syndrome, or capture-bonding, is a psychological phenomenon in which hostages express empathy and have positive feelings towards their captors, sometimes to the point of defending them. These feelings are generally considered irrational in light of the danger or risk endured by the victims, who essentially mistake a lack of abuse from their captors for an act of kindness.

Now, the health care connection. As a result of the billions of …

Stop penalizing doctors for effectively using EHRs

Margalit Gur-Arie

Health Technology

October 31, 2012

The health care crowd is abuzz with the New York Times revelation that Medicare billing rates seem to have increased by billions of dollars in parallel with increased adoption of EHR technologies for both hospitals and ambulatory services. The culprit for this unexpected increase is the measly E&M code.

Evaluation and Management (E&M) is the portion of a medical visit where the doctor listens to your description of …

Why venture capitalists shouldn’t try to solve health care

Margalit Gur-Arie

Health Technology

October 24, 2012

I recently wrote a post about the clueless, but endearing, enthusiasm of technology people as applied to solving the health care problem.

Dr. Davis Liu published a post describing the vision of Vinod Khosla, the famed venture capital maven, of replacing doctors with machines. It turns out that Mr. Khosla wrote a series of three articles at the beginning of the year …

Digital medicine: Patients are stuck in the precarious middle

John Schumann, MD

Health Technology

October 15, 2012

The use of computers in everyday medical practice has finally reached the tipping point.

The HITECH Act, part of the 2009 federal stimulus bill, has been the final kick in the pants that U.S. health care has long needed to make the conversion to digital. The act states that, by employing electronic health records (EHRs) in a fashion known as meaningful use, doctors are individually eligible for …

Don’t ever believe EHR uptake is slow only because it costs too much

Rosemarie Nelson

Health Technology

October 13, 2012

The latest numbers from the CDC’s National Center for Health Statistics affirm that a majority of small practices do not have an EHR. Why is that?

One big reason is because small practices don’t have the management or technical infrastructure available to prepare for and handle the biggest challenges facing medical practices today.

What are those challenges and what’s that got to do with EHR implementation? According to the Medical …

What EMRs are doing to our notes, and our brains

Robert Wachter, MD

Health Technology

October 11, 2012

A colleague recently sent me a remarkable video – of Professor Lawrence Weed giving Medical Grand Rounds at Emory University in 1971. It’s fun to watch for many reasons: the packed audience composed mostly of white men in white jackets and narrow ties, the grainy black and white images a nostalgic reminder of Life Before High Def.

But the real treat is …

Should medical students learn how to use an EHR in medical school?

Ishani Ganguli, MD

Health Technology

October 4, 2012

Outside a patient’s room in the cardiac intensive care unit (CICU), a senior doctor, a nurse, and several residents in various stages of wakefulness cluster for morning rounds. Each resident mans a computer-on-wheels (once called a C.O.W., the acronym was formally abandoned at MGH, legend has it, after a patient thought it was directed at her and took offense).

One of the residents reads off laboratory test results from the patient’s …

Health IT: We can fix health care, and we know exactly how to do it

Margalit Gur-Arie

Health Technology

September 27, 2012

High tech people are very enthusiastic people. We are optimistic, confident and creative and if I may be allowed to say so, really, really smart. We start out by saying “Hello World!” not “Hi, I’m Jack or Jane”. We hail the entire Universe and assume it knows who we are, or that it will soon find out, because the sky is not the limit and we are going to change …

4 reasons why doctors need to drive health care technology

David Lee Scher, MD

Health Technology

September 25, 2012

The physician’s role is drastically changing. More and more physicians are becoming institutional employees. More patient encounters are performed via non-physician providers. The increasing regulatory demands on physicians are consuming an inordinate amount of their time. Stress and burnout are universal to some degree. Both the financial and emotional rewards of practicing medicine have greatly diminished. They are becoming more quality control officers than healthcare providers. However, physicians will never …

How to destroy health IT innovation

Douglas Perednia, MD

Health Technology

September 21, 2012

I have spent a good portion of his career working to come up with ways to make healthcare better, faster and cheaper through the appropriate use of computer and information technologies. Given the vitriol that I have periodically heaped upon many of the electronic medical record systems commonly deployed and mandated by the government, this enthusiasm for computers and telecommunications may come as a bit of a surprise to some …

Read more…

How to destroy health IT innovation

How can technology entrepreneurs disrupt health care?

Davis Liu, MD

Health Technology

September 17, 2012

I recently viewed health care through the lenses of a technology entrepreneur by attending the Health Innovation Summit hosted by Rock Health in San Francisco. As a practicing primary care doctor, I was inspired to hear from Andy Grove, former CEO of Intel, listen to Thomas Goetz, executive editor of Wired magazine, and Dr. Tom Lee, founder of One Medical Group as well as ePocrates.

Not surprising, the most fascinating person, …

Can digital medicine have a placebo effect?

Dike Drummond, MD

Health Technology

September 9, 2012

Is the placebo effect something that demands the presence of a living human – or can we program it into a cell phone app? What happens to healthcare if we can?

I must admit I have always been fascinated by the concept of placebos. You give a research subject with a documented medical condition a sugar pill – and they get better. They heal themselves despite the fact they have not …

ACP: My EHR report card

Yul Ejnes, MD

Health Technology

September 6, 2012

A guest column by the American College of Physicians, exclusive to KevinMD.com.

Even though September is “back to school month” and students won’t get their report cards for a while, I have a report card to share with you now. In September 2006, my practice went “live” with an EHR, so I thought that the sixth anniversary of this …

Read more…

ACP: My EHR report card

Striking the balance between the public good and patient privacy

Margalit Gur-Arie

Health Technology

September 6, 2012

Everybody has a shadow. Although as a small child you may have tried, you cannot separate yourself from your shadow no matter what you do. Electronic medical records may be the first tiny step on the road to attaching yet another indivisible part to your persona, a “panoramic, high-definition, relatively comprehensive view of a patient that doctors can use to assess and manage disease”, and this, in the words of …

View medical apps with caution, just like any new medical device

Kenneth Lin, MD

Health Technology

September 4, 2012

Doctors of my generation have experienced dramatic changes in the way we access the information we need to care for patients. As a medical student 15 years ago, my “peripheral brain” consisted of fat textbooks sitting on office bookshelves or smaller, spiral-bound references stuffed into the bulging pockets of my lab coat. As a doctor-in-training, I replaced those bulky references with programs loaded onto PDAs. Today, smartphone apps allow health …

How to create YouTube videos for patient education

Neil Baum, MD

Health Technology

September 2, 2012

Many doctors are now getting into movie production and making videos that are loaded onto YouTube. These videos are effective in attracting new patients and educating your existing patients. There are a few guidelines that you can use to create an effective script for each of your videos. These scripts can be loaded onto your computer in a PowerPoint format and will serve as poor man’s teleprompter to assist in …

10 ways to make an EMR truly meaningful for doctors

Rob Lamberts, MD

Health Technology

August 29, 2012

I am an EMR geek who isn’t so thrilled with the direction of EMR. So what, I have been asked, would make EMR something that is really meaningful? What would be the things that would truly help, and not just make more hoops for me to jump through? A lot of this is not in the hands of the gods of meaningful use, but in the realm of the demons …

Why we need to suffer the growing pains of electronic health records

Richard Just, MD

Health Technology

August 22, 2012

My group purchased our electronic health records system (EHR) about 5 years ago. We had 4 clinical practice locations (soon to be 5 1/2) with 1 administration office. None of these sites are close to each other. A major reason for purchasing an EHR was, and still is, to collect and analyze all data from our entire practice for the purpose of determining outcomes of our treatments. In other words, …

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