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.

Electronic records don’t tell us stories that make cognitive sense

Karen S. Sibert, MD

Health Technology

May 10, 2012

One morning recently, I found another physician standing morosely at one of the mobile computer terminals we refer to as “cows”—computers on wheels—that are everywhere now in our hospital. I asked what was the matter. “Oh nothing, really,” she said. “It’s just that I don’t feel I know the patients as well as I used to.”

I knew exactly what she meant. Things are different now that we have the EMR—the …

How an EMR makes connecting with the patient more difficult

Shabbir Hossain, MD

Health Technology

May 6, 2012

I have the great privilege of being a medical educator. Everyday, I have an incredible time working with internal medicine residents at their continuity clinic, teaching the art of ambulatory medicine. Our working environment here is academically rich and fulfilling. The name of the legendary Dr. Martin Leibowitz (an iconic figure in ambulatory medicine here) stands outside our conference room as a constant reminder of how medicine is practiced and …

Should electronic medical records be considered medical devices?

Wes Fisher, MD

Health Technology

May 4, 2012

In our rush to establish a national electronic medical record (EMR) system as part of the American Recovery and Reinvestment Act of 2009, powerful silos of independent EMR systems have sprung up nationwide. While most systems are being developed responsibly, like the Wild, Wild West, many have been developed without an objective eye toward quality and the potential harm they may be causing our patients.

As most readers of this blog are aware, …

What keeps a hospital CIO up at night

John Halamka, MD

Health Technology

April 28, 2012

Earlier this year, my team presented a list of risks to the Compliance, Audit and Risk Committee at BIDMC. Here’s my list of top risks for 2012:

1. Old Internet browsers. Many vended clinical applications require specific versions of older browsers such as Internet Explorer 6, which are known to have security flaws. We’ve worked diligently to eliminate, upgrade or replace applications with browser specificity. At this point we …

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What keeps a hospital CIO up at night

Why mobile health devices need FDA oversight

David Lee Scher, MD

Health Technology

April 19, 2012

Everyone has heard of a recall of a consumer product such as a component of an automobile, child’s toy, or an over the counter medication. A recall of those types of products often implies taking them off the market as well as replacement or repair (in the case of device or car components).

During my 20 years as a practicing cardiac electrophysiologist, I witnessed firsthand the evolution of how implanted medical …

How can doctors curb digital distractions?

Robert Wachter, MD

Health Technology

April 18, 2012

It’s been said that losing weight is much harder than kicking cigarettes or alcohol. After all, because one doesn’t need to smoke or drink, the offending substances can simply be kept out of sight (if not out of mind). Dieting, on the other hands, involves changing the way a person does something we all must do everyday.

It’s no surprise, then, that reports of problematic doctor interactions with social media are …

We need to systematically evaluate digital health technologies

Fard Johnmar

Health Technology

April 15, 2012

An old colleague once told me: “When you assume it makes an ass out of u and me.”

Many of us would consider being an ass a bad thing. If so, why are we making so many assumptions about digital health? Belief in the power of digital technologies to solve a host of pressing problems in health has us poised to devote billions of dollars to their adoption and development. But …

Embrace the explosion of the new technologies

Gary Oftedahl, MD

Health Technology

April 13, 2012

The world of health care today is much different than the one I became involved in as a physician over 35 years ago. But why should that surprise me? The world in general is so dramatically changed from that which I knew then, it would seem reasonable and totally understandable that we’ve had to make dramatic changes in how we work with the population in maintaining health. Or have we? …

Is the quantified self movement the future of American health?

Kent Bottles, MD

Health Technology

April 6, 2012

If you cannot measure it, you cannot improve it.
-Lord Kelvin

Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry.
-Nassim Nicholas Taleb

Of course the quantified self movement with its self-tracking, body hacking, and data-driven life started in San Francisco when Gary Wolf started the Quantified Self blog in 2007. By 2012, there were regular meetings in 50 cities and a European and American conference. …

Why Facebook should be a template for electronic medical records

Chris Rangel, MD

Health Technology

April 5, 2012

The Internet beta 0.5 version was nothing like it is today. Back in the ’80s and the early ’90s the most common way to access the outside world was to use a phone modem to dial the number of a remote computer. These primitive servers usually ran DOS based software called a Bulletin Board System (BBS) which allowed users to post messages to each other. For the most part, these …

How doctors should adopt new technology

Donald Tex Bryant

Health Technology

April 3, 2012

My primary care physician, the last time I was in for a checkup, had not adopted ePrescribing or started using an electronic health record (EHR). My understanding is that the medical group to which he belongs had not rolled out these capabilities to him yet but was planning to do so. Hopefully, this summer when I see him again he will be plugged into the electronic health record that the …

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How doctors should adopt new technology

Doubting the cost savings of health information technology

Jennifer Shine Dyer, MD, MPH

Health Technology

March 31, 2012

A recent Health Affairs article casts doubt on the cost-saving prospects of health information technology despite the significant investments made by hospitals, physicians, and the federal government to promote electronic records.

Reduced ordering of imaging and other diagnostic studies by physicians is often cited as a likely mechanism for estimated cost savings due to health information technology. Possible mechanisms include reduction in redundant (duplicated) tests secondary to better access to …

Small opportunities to use mobile technology in medicine

Karim Jessa, MD

Health Technology

March 30, 2012

As citizens of the 21st century, we seem to have adapted personal technology for every conceivable use — Siri, the iPhone’s newest darling, can literally remind us to call a proctologist. But as physicians, we may be missing some of the best opportunities to derive “meaningful use” from technology.

I am an emergency physician, and a few nights ago I worked a shift in the ER. It was a typical, …

Eventually in healthcare, there will be an app for that

Mark W. Browne, MD

Health Technology

March 29, 2012

As a traveling consultant, I eat at a lot of restaurants on the road and am frequently short on time when I do. I have had to learn to live with the very inefficient current model of business in restaurants. Wait to be seated, order your beverage, wait again, hear the specials, order my meal, wait some more, eat my meal, wait for the check, pay the bill, wait again, you …

Health information exchanges and the problem of consent

Adrian Gropper, MD

Health Technology

March 25, 2012

Will health information exchanges provide patient access portals or not?

There are 60 or so regional health information exchanges (HIEs) in the works. They are beset with issues: technology, regulations, competing stakeholders, payment reform uncertainty, sustainability and consent. The last thing they need, it seems, is citizen clients.

It turns out that HIEs have a choice of strategies, at least in the next year or two. Now that proposed Stage 2 Meaningful …

Technology will democratize medicine

Lawrence Hofmann, MD

Health Technology

March 25, 2012

Patients are more empowered with their medical decisions, more than ever. With the Internet, they are able to research their conditions and can sometimes diagnose their conditions and treatment without having to step in the office. “Dr. Mom” can find useful information on treating their infant’s cold at 2 am.

However, when there are serious chronic conditions, patients want an expert. Patients can get information on the disease – the government, …

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Technology will democratize medicine

Is the patient experience enhanced by modern technology?

Robert Rowley, MD

Health Technology

March 19, 2012

Most physicians went into the practice of medicine motivated (at least in part) by the reward that comes from that human-to-human connection. The reward that comes from helping people. It was true of my generation of physicians, it was true of those before me, and is true of newer generations of physicians who grew up in a more interconnected, digitized world.

We are now at a time in medicine where an …

Why doctors aren’t prescribing health apps to patients

Travis Good, MD, MBA

Health Technology

March 19, 2012

The BBC had a story recently about general practitioners (GPs) in the UK prescribing health apps to patients. The idea is that prescribed apps would be free to patients, even if they had a cost associated with them, so I’m assuming that the NHS would pick of the tab for such apps.

The story has gotten a lot of attention, and I think with good reason. I’ve written before and …

Cardiac device patients should lead patient portal adoption

David Lee Scher, MD

Health Technology

March 13, 2012

I have previously focused on issues specific to patients with implantable cardiac rhythm devices who deserve to access their device’s own data directly via patient portals or PHRs. What I would like to suggest is that if this PHR becomes a reality soon, that it will lead to widespread adoption of patient portals in general. Remote monitoring of implantable cardiac rhythm devices was the first widespread use of remote …

Addressing the security risks of healthcare IT

Steve Lorenz

Health Technology

March 7, 2012

As an IT person working for a hospice company I am constantly attempting to find a harmonious balance between implementing technological advancements and mitigating security risks. In other sectors, IT departments can have something akin to carte blanche when it comes to new technologies and services.

The world of healthcare is often a bit slower to adopt new technology for a multitude of reasons, not the least of which being the …