What medicine will be like 20 years from now

Tech
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 …

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What medicine will be like 20 years from now

Pros and cons of cloud based or web based EMR systems

Tech
May 18, 2011

As if medical practices don’t have enough to worry about with EMR implementation, now they have to decide what kind of EMR system to get: a client-server-based system or a web-based system. The former is the kind that most of us are familiar with. You purchase a computer server, buy a license for the EMR software, install said software on your server, …

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Pros and cons of cloud based or web based EMR systems

Using Google Translate in medicine

Tech
April 21, 2011

by Graham Walker, MD

In The Hitchhiker’s Guide to the Galaxy, the Babel Fish was a fish you stuck in your ear that allowed you to understand any language spoken to you. We’re not far off.

Google recently released a new version of their (free!) Google Translate app for Android phones, featuring conversation mode, which allows you to have a back and forth …

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Using Google Translate in medicine

Patients Google their symptoms, doctors need to deal with it

KevinMD
January 20, 2011

Many doctors roll their eyes whenever patients bring in a stack of research they printed out, stemming from a Google search of their symptoms.

A piece by Zachary Meisel in TIME.com describes a familiar scenario:

The medical intern started her presentation with an eye roll. “The patient in Room 3 had some blood in the toilet bowl this morning and is …

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Patients Google their symptoms, doctors need to deal with it

Converting paper charts to electronic medical records tips

Tech
September 24, 2010

We are a little over two years into our electronic medical records implementation at the time of this writing. Since we have been performing a gradual rollout, the entire process has been relatively uneventful. Most of the credit for this goes to our chief information officer (technospeak for the head of our IT department) and our practice administrator.

One of the biggest challenges we have been facing is how to convert …

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Converting paper charts to electronic medical records tips

Apple’s iPad on medical rounds, a hands on physician review

Tech
August 13, 2010

by Felasfa Wodajo, MD

Recently, we had the chance to check in with Dr. Henry Feldman. He had posted a detailed summary of his experiences using the iPad as his main interface while rotating on service for a week as a hospitalist at Beth Israel Deaconess hospital (BIDMC) in Boston. Dr. Feldman is also Chief Information Architect for the Harvard Medical Faculty Physicians.

The summary of the …

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Apple’s iPad on medical rounds, a hands on physician review

How to implement CPOE successfully at your hospital

Tech
July 9, 2010

One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes. This has created a new urgency for all hospitals in the state to install computerized physician order entry (CPOE).

At BIDMC, we implemented CPOE in 2001 and have not had a handwritten order in most areas, except for the 2 days of our network outage in 2002. Implementing CPOE is challenging and requires …

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How to implement CPOE successfully at your hospital

Problem list problems with electronic medical records

Tech
May 4, 2010

In family medicine it has been common to keep a “Problem List” in patients’ paper charts. Usually placed on the left hand side, on top of the Medication List, it has given doctors like me an instant thumbnail sketch before considering the specifics of each patient’s visit for that day.

A typical Problem List would include diagnoses like diabetes, hypertension, high cholesterol or rheumatoid arthritis. It would list prior surgeries, like …

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Problem list problems with electronic medical records

Free iPhone medical apps that every doctor can use

Tech
March 3, 2010

by Iltifat Husain, Yousif Alkadhi, MD, and Satish Misra

If you’re a physician, medical student, or in any other health care related field, trying to find the best free medical apps for the iPhone is a hassle.

Apps such as “Dream Meanings”, “Relax Ocean waves”, and “Stool Scanner Lite” dominate the Top Free Medical Apps list in the App Store. Our top 10 iPhone medical apps list contains no such app, …

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Free iPhone medical apps that every doctor can use

10 ways an Apple iPad can help doctors improve patient care

Tech
February 2, 2010

The current (first generation) Apple iPad probably won’t run a robust electronic health record (EHR).

apple ipad However, it may run some iPhone/iPod touch EHR/EMR apps. I think most physicians will prefer to use a standard tablet PC instead of the iPad. However, given that a large percentage of physicians are not using the tablet in the outpatient office setting, perhaps …

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10 ways an Apple iPad can help doctors improve patient care

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Why there needs to be a national healthcare information database

Tech
January 24, 2010

The majority of Americans have a great deal of personal health information in their physician’s medical record. Many of these physicians have an electronic healthcare record (EHR) to store this information.

Unless you are in an integrated healthcare system, and most Americans are not, this information is just not available to you or any physician seeing you who does not belong to the same physician group as your primary physician. Even …

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Why there needs to be a national healthcare information database

The physical exam is useless

Uncategorized
February 8, 2006

I have written before that the physical exam is useless in American medicine:

This is why the physical exam is useless in American medicine – it cannot hold up in court. Clinical evaluation and judgment skills now needs to be supported with objective, and often expensive, tests. Here we have a case of three separate physicians who, in their clinical opinion, did not feel a CT scan was warranted. …

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The physical exam is useless

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