Health IT

The burden of the documentation and administrative tasks on physicians needs to be lightened significantly

Physician
July 19, 2021

It takes a special person to care for people during their most vulnerable states, to keep intimate details about people while remaining compassionate even toward the seemingly vilest of persons. The white color of a physicians’ coat can be a metaphor for the purity expected of physicians. A physician’s signature or words carry weight. With such power comes the responsibility to be trustworthy.

Documentation is an important part of patient care. …

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The rise of non-traditional nursing

Tech
July 7, 2021

Nurses are an essential component of the American health care system and are continually in high demand nationwide. For years, nurses have elected to leave the field or have sought alternative professions instead of working in a traditional nursing role full-time. The pandemic brought into focus the need for work-life balance across professions. Whether strained from high-stress levels, financial upset, demanding hours or an overwhelming workload, nursing …

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Doctors now must provide patients their health data, online and on demand

Policy
May 22, 2021

Last summer, Anna Ramsey suffered a flare-up of juvenile dermatomyositis, a rare autoimmune condition, posing a terrifying prospect for the Los Angeles resident: She might have to undergo chemotherapy, further compromising her immune system during a pandemic.

After an agonizing three-day wait, the results of a blood test came back in her online patient portal — but she didn’t understand them. As hours passed, Ramsey bit …

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Bloated notes are a huge problem and a time suck

Physician
May 4, 2021

In a moment of caffeine-depleted delirium, I volunteered to head the creation of a “notes committee” for my 80-member hospitalist group.

I placed myself on a 72-hour hold and quickly established a group consensus: “Bloated notes are a huge problem and a time suck. I’m glad you [rather than me] are working on this. My notes are fine, though. It’s other people’s notes that are bad. Other people’s bad notes are …

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Where’s Waldo: Finding what’s important in the medical record

Physician
September 29, 2020

I did a peer review once of an office note about an elderly man with a low-grade fever. The past medical history was all there, several prior laboratory and imaging tests were imported, and there was a long narrative section that blended active medical problems and ongoing specialist relationships. There was also a lengthy review of systems under its own heading.

In an over ten-page long printout, the final diagnosis was …

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An EMR frustration that is still torturing us

Tech
September 18, 2020

I have written, or more accurately ranted, about electronic medical records (EMR) systems throughout this blog. While the systems have clearly improved since their mandatory introduction into the medical universe, they have still not delivered on many of their promises.

Of course, EMR has brought tremendous advantages to the medical profession, and we are all grateful for the technology. But this progress has exacted a cost. Many of them are clumsy …

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What can patients do to lower the risk of errors in their electronic medical records?

Physician
May 17, 2020

In a perfect world, an electronic medical record would aggregate a patient’s medical information from all health care providers into a single, comprehensive record that could be easily accessed by any provider with the patient’s permission. This information could reduce the risk of medical errors, duplicate testing, and inappropriate treatment and the associated cost of these mistakes. It could also be lifesaving in the event of a medical emergency that …

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Doctors, a tech revolution is coming

Tech
January 31, 2020

What if I told you just a few years ago that Amazon — a budding e-commerce startup — would come to disrupt the multi-billion dollar retail industry.

I seriously doubt that anyone could have given it a serious thought. At least not in the magnitude that will force a slew of big-box retailers to shut their doors for good.

I am sure the same response would have been elicited about Uber and …

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Why electronic medical records should be standardized

Physician
October 22, 2019

How can we possibly get to standardization in medicine? And is that a good thing?

Standardized checklists save lives; rigid procedures for sterilization of equipment saves lives; universal compliance with recommended beneficial treatments saves lives. And while it’s sometimes a wonderful thing to let a surgeon solve a problem creatively or to allow a patient visit to go overtime in order …

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The keyboard is the sworn enemy of physicians

Tech
September 26, 2019

During one long ago very hot Washington, DC summer, at the suggestion of my parents, I enrolled in a typing course that was given at our elementary school.

This was the summer between sixth and seventh grades, and there were lots of things I would’ve preferred to have been doing, but my dad, who started out in advertising, felt that touch-typing …

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Who actually owns your medical records?

Physician
September 25, 2019

I was in a discussion with a group of patients about how difficult it is for patients to get access to their own medical records. It was initiated after one of my patients was refused copies of her recent hospitalization. There is much confusion out there about who actually owns the record and how it is allowed to be accessed. Most people are aware of HIPAA, the regulation set into …

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Virtual scribes are game-changers for physicians

Tech
September 16, 2019

Today was like no other day. It was our first day together.

Me and my “virtual” scribe — an actual person who seems to “virtually” to exist inside of a Jabra speaker on my desk and so subtlety that I forgot to mute a few times when not seeing patients. The “man” in the Jabra speaker now knows just how long of an appointment I need for my hair, and that …

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How EMRs can actually help physicians

Tech
September 12, 2019

Collaboration is the key.

When I think about how hard it is to take care of our patients, and how many different people are involved in their care, it’s a wonder that anything ever gets done.

We need to simplify systems, and harness the power of the information systems available to us, as well as the promise of the electronic medical record, …

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5 clinician concerns about OpenNotes

Tech
September 12, 2019

More than 200 health organizations have now implemented OpenNotes. Many more are piloting, are soon to implement — or have implemented, and we don’t know it! For more than three years I’ve been fortunate to represent OpenNotes to potential implementers, and I’m confident I’ve heard almost every clinician concern or anxiety regarding what might happen when patients read their own notes.

Here are the five most common concerns I’ve heard — …

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A slow death by charting

Tech
September 10, 2019

It’s 10 p.m.

Seven days before Christmas.

I’m sitting at work “finishing” up some charts.

I am suddenly overcome with anger.

What am I doing here right now at this minute? I am helping no one.

This work I’m typing away at — trying so hard not to scream — it’s hoops. Fucki*g hoops … for insurance companies. So I can beg them to pay me. Pay me pennies for the hard, good, compassionate, humanitarian …

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When physicians focus more on screens than patients

Tech
July 29, 2019

As Wei Wei Lee sat with her doctor to discuss starting a family, she felt a “distance” between them. The physician was busy on the computer and focused on the screen.

“It just didn’t feel very personal,” Lee said. “I didn’t feel heard.”

It seemed as though keeping a record of the conversation was more important to the doctor than making a connection with Lee.

It wasn’t the experience she wanted, but she …

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