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.

Protecting health apps on the web from the evils of the Internet

John Halamka, MD

Health Technology

October 3, 2011

The Internet can be a swamp of hackers, crackers, and hucksters attacking your systems for fun, profit and fraud. Defending your data and applications against this onslaught is a cold war, requiring constant escalation of new techniques against an ever increasing offense.

Clinicians are mobile people. They work in ambulatory offices, hospitals, skilled nursing facilities, on the road, and at home. They have desktops, laptops, tablets, iPhones and iPads. Ideally …

Few doctors will meet meaningful use in 2011, and that’s ok

Brian Klepper, PhD and David C. Kibbe, MD, MBA

Health Technology

September 26, 2011

2011 will be a disappointing year for the Centers for Medicare and Medicaid Services and the Office of the National Coordinator’s electronic health record incentive programs. We predict that few doctors and hospitals will meet the objectives set for the “meaningful use” of certified EHR technology. Meaningful use is, of course, the term that describes the objectives and measures providers and hospitals must meet in order to receive financial bonuses …

Mobile technology will be omnipresent in health care

Douglas Elwood, MD, MBA

Health Technology

September 23, 2011

A white paper from The Beryl Institute reveals a 10% increase in general patient satisfaction and over 40% improvement in satisfaction with educational materials at hospitals when interactive technology is provided.

The publication examines six different hospital systems using the industry-standard Hospital Consumer Assessment of Healthcare Providers and Systems survey for evaluation. According to a press release on the study, the technology gave patients faster access to hospital staff and services by submitting …

Legal weaknesses of an electronic medical record

Mike Koriwchak, MD

Health Technology

September 23, 2011

Over the past several months I have read several online discussions and comment threads on the medical-legal issues raised by EMR, including an HIMSS brochure on the subject. Most of these discussions miss what I consider to be the most important legal weaknesses of an electronic medical record. I finally came across an online discussion that comes closer to covering what I consider to be the most important …

Social gaming to engage patients and improve wellness

Travis Good, MD, MBA

Health Technology

September 14, 2011

Social connectivity to engage patients has real the potential to impact health through improvements in lifestyle, the main driver of wellness. This is in increasingly shorter supply as we collectively increase pounds, cholesterol, and blood pressure readings.

Many have written compellingly on why social matters for health. The best I’ve seen are a post by Jay Parkinson (of Hello Health and Fast Company fame) that borrows from Atul …

My iPad and my hip fracture

Paul Hsieh, MD

Health Technology

September 12, 2011

Dear Apple:

I’ve been a happy iPad2 owner since March 2011, but I never fully appreciated its value until I recently broke my hip in a bad fall and required subsequent hospitalization.

I am a physician, so I had already been using my iPad for my work, reading PDFs of medical articles, communicating with my colleagues via e-mail, etc. But when I broke my hip in an accident a few days ago, …

Read more…

My iPad and my hip fracture

How an EHR will impact physician productivity

Robert Rowley, MD

Health Technology

September 10, 2011

One of the big concerns about implementing an electronic health record (EHR) into a medical practice is the fear that it will slow you down. In fact, after cost, usability (and its effect on productivity) is the second-biggest perceived barrier to EHR adoption.

Numerous studies have shown that EHR implementation actually ends up saving cost in a group practice, mainly because of reducing or eliminating the need for paper-based medical …

The threat of technology to proper patient care

Josh Herigon, MPH

Health Technology

September 9, 2011

Dr. Abraham Verghese wrote in the New York Times recently about the threat of technology to proper patient care. This is an excellent piece and although I do not disagree with the overall message, I think Dr. Verghese conflates different issues currently plaguing our health care system.

Below, I provide some comments on a few of the major points Dr. Verghese writes about: “This computer record creates what I call an “iPatient” …

Telemedicine to augment the patient encounter

John Schumann, MD

Health Technology

September 8, 2011

When I use the term “telemedicine,” what does it mean to you?

In current parlance, it usually refers to radiologists looking at digital images of x-rays and other scans from locations remote from the site of acquisition. Think “outsourcing” where the radiologist could even be as far away as India.

But according to a recent conference I attended, telemedicine could mean so much more. It can range from synchronous video chat …

Tips for doctors looking for the right EHR

Margalit Gur-Arie

Health Technology

September 3, 2011

Here we are going to talk about the second stage of shopping for an EHR. We are going to assume that you did your homework, defined your goals and constraints and prepared a comprehensive list of requirements for an EHR (if you have not done so already, go back and read part 1).

To continue our car shopping analogy, we are now ready to go kick some tires, and …

Natural language processing in electronic health records

Joe Petro

Health Technology

September 1, 2011

80 percent of the clinical documentation that exists in healthcare today is unstructured. It is sometimes referred to as “the text blob” and is buried within electronic health records (EHRs). The inherent problem with “the text blob” is that locked within it lies an extraordinary amount of key clinical data – valuable information that can and should be leveraged to make more informed clinical decisions, to ultimately improve patient …

How government can improve EMR usability

Jonathan Baran

Health Technology

August 31, 2011

Government involvement in usability has been the talk recently. In case your not aware, EMR usability is such as problem the government is exploring ways to get involved. As you might imagine the topic is a very sticky subject, especially EMR vendors, as the topic conjures images of committee-centered design and EMRs being worse of then they already are now.

However, when you think objectively about it, I believe the government …

Properly delete electronic medical records, or face fines

Pamela Wible, MD

Health Technology

August 30, 2011

Could a complete stranger receive your echocardiogram results in the mail?

Could a homeless guy in Boston end up with your labs in his shopping cart?

Is it possible that your medical records were sold on eBay?

Yes. Yes. And yes.

On February 24, 2011, Massachusetts General Hospital was fined $1 million dollars by the federal government when an employee inadvertently left a stack of papers on the subway. These documents contained the …

Will patients trust sociable humanoid robots?

Kent Bottles, MD

Health Technology

August 25, 2011

Within in five years primary care providers will begin being replaced by sociable humanoid robots, avatars, and computer programs. Within ten years you will no longer hear any complaints about medical students choosing specialty residencies over family practice because the role of the physician will be completely redefined to complement a rules based approach to the diagnosis and treatment of many diseases. This transformation is inevitable because of demographics, economics, and …

Practices have failed to analyze the clinical content of their EHR

Ron Sterling

Health Technology

August 20, 2011

Clinical content refers to the various checklists, documents, and forms that address an area of medicine when using an EHR. For example, a pediatric practice would be interested in documentation tools for a newborn visit. Not all EHRs have clinical content for all areas of medicine. For example, some EHRs have clinical content for internal medicine, but lack the details needed for dermatology or cardiology.

A disturbing number of practices …

Medical device innovation saves lives but often at a high cost

Stephen C. Schimpff, MD

Health Technology

August 19, 2011

Innovation in medical devices has been profound in recent years – cardiac devices are a good example. The combination of engineering advances to create small, strong and wear-resistant devices and computational advances with smaller and smaller semiconductors loaded with more and more information have led to truly amazing advances. With more and more people with more and more chronic illnesses, the need is great and the opportunities for innovators is …

Chronic disease management through mobile health

Barbara Ficarra, RN, MPA

Health Technology

August 17, 2011

The conundrum continued behind conference doors at the American Telemedicine Association (ATA) conference in Tampa about the efficacy of mobile phone usage to improve patient health.

Lively discussions followed about the ROI for chronic disease management through mobile health and outcomes for remote patient monitoring focusing on whether telemedicine is excluded from meaningful use and reasons why telehealth should be a key component in Accountable Care Organizations (ACO).

As the debate …

What medicine will be like 20 years from now

Aaron J. Stupple, MD

Health Technology

August 13, 2011

I was asked recently to predict the practice of medicine in 20 years. After stating that any such prediction is massively speculative, I indulged because it is massively fun.

I am persuaded by Clayton Christensen’s arguments in The Innovator’s Prescription that healthcare will go the way of other massively disrupted industries, wherein healthcare will follow the arc of decentralization.

Using the music industry as an example, the arc begins …

Why is the iPad be revolutionary for doctors and nurses?

Jared Sinclair, RN

Health Technology

August 13, 2011

As a nurse, I spend a lot of time with other nurses. When they ask me to explain why I think the iPad is great, I respond with the following metaphor: imagine that you are a nurse who has been asked to design a new hospital from scratch. You are free to question every prior assumption, to throw out old ideas that no longer fit, to redesign everything according …

Are our privacy rules robust enough to protect our patients?

Dan McCoy, MD

Health Technology

August 12, 2011

Ok, imagine this.

You take a video of your little girl’s soccer practice with your iPhone. Within moments it’s posted on YouTube for the grandparents to see.

Minutes later search engines called spiders begin to crawl across the data set of images on your upload. Face recognition technology identifies a face on the video and, with some assistance from the geo-tagging of the built in GPS metadata that accompanied the upload, …

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