Citing slow load times, confusing menu structure, and overall frustration with the user interface, St. Barnaby’s Hospital has announced that the old electronic health record (EHR) will be replaced with a new state of the art binder-based system, in which a so-called “paper chart” is kept for each patient.
The new …
Hospital replaces EHR with new, efficient “paper chart” system
While the electronic medical record (EMR) has advantages, it also has introduced liability risks. EMRs can lead to lawsuits or result in a weak defense by casting the physician in an unfavorable light.
For example, examine these exchanges in a recent malpractice trial:
EMRs can hurt physicians during lawsuits. Here’s how.
An article from the JAMA has been gnawing at my consciousness for the last couple of weeks. Dr. Prashant Kaul and colleagues out of the University of North Carolina reviewed records from hospitals in the state of California from 2008 through 2011, looking for patients who had been hospitalized with heart attacks. Specifically, they were looking for patients with ST elevation …
Why does treating heart attacks cost so much money?
One of the major reasons that health care providers resist implementing an electronic medical record (EMR) system is the belief that using it will decrease provider productivity, reducing the number of patients they can see and therefore reducing practice revenue.
However, an EMR that is designed around a streamlined workflow can enable providers to work faster and more efficiently. Having an EHR and vendor that can give you ongoing visibility and …
5 ways to increase your EMR efficiency
It has been 5 years since the passage of the HITECH Act portion of the Affordable Care Act. The purpose of HITECH was “to promote the adoption and meaningful use of health information technology.” While the result of this legislation has been the significant increase in the adoption of EHRs, most of the potential benefits of digital technology have yet to be demonstrated. there are multiple reasons for this lack of proof.
The portions of …
5 reasons why physician champions are needed
Why do so many seemingly great technologies fail to penetrate the health care system?
I hope the following five answers shed some light on the realities of technology adoption in health care.
1. Many new technologies don’t address the real problem
Tech entrepreneurs often take a backward approach to invention. They start by discovering a nifty technology. Later, they figure out how people can use it.
This technique often teaches entrepreneurs a tough lesson: Technology …
Health care fails to adopt technology. Here are 5 reasons why.
Imagine you go to work one day and your boss says all employees will be evaluated based on the performance of a new set of job skills that require additional training and, perhaps, new computer hardware and software. The boss also announces that some employees will be reimbursed for the cost of acquiring these skills and tools. You aren’t among this privileged group.
In government, this is called an unfunded …
Psychiatric hospitals need meaningful use incentives
As I look back all those years ago to when I chose medicine as a career, I suspect that my motives were similar to most people who enter this wonderful profession. I wanted to become a doctor because I had a genuine and sincere desire to help people. I also liked the idea of a busy and energetic job, one where I was comfortably as far away as possible from …
The human side of medicine that no computer can ever touch
A recent article on American Medical News titled “Medical charting errors can drive patient liability suits” led with a case involving a bad outcome after coronary artery bypass surgery. The plaintiff’s attorney alleged that the doctors did not review the patient’s lab results or x-rays because they did not specific say so in the medical record.
The article quoted a defense attorney who said, “By the time [the doctors] are deposed, …
In the Boston marketplace, Partners Healthcare is is replacing 30 years of self developed software with Epic. Boston Medical Center is replacing Eclipsys (Allscripts) with Epic. Lahey Clinic is replacing Meditech/Allscripts with Epic. Cambridge Health Alliance and Atrius already run Epic. Rumors abound that others are in Eastern Massachusetts are considering Epic. Why has Epic gained such momentum over the past few years?
Watching the implementations around me, …
Boston hospitals go Epic: Hear from a holdout
Who is responsible for mistakes in health care? Who should take credit for success or blame for failure? Most families, patients and obviously the courts, hold the doctor responsible. It seems to me this is reasonable; it is the obligation physicians assume and which society returns with empowerment and respect. However, is this changing because of the Internet and big data?
In 2013, most patients have spent hours on the Internet …
Are physicians still responsible for mistakes in health care?
Dear Graduating Class of 2013,
I appreciate the opportunity to address such an impressive pool of medical school attendees. From the first day of medical school when you were introduced to your cadaver, you have endured countless lectures and lab hours, physical examination and sensitivity training sessions, and ward rotations under the watchful eye of senior residents and attendings. Today, you will hold something that few people are privileged to …
A powerful address to graduating medical students
I overheard nurses praising the pilot of a new technology with the promise of improving communication, safety, and saving on healthcare spending. The innovation: two-way texting. That’s one of the many indicators that hospitals are stuck the technological stone age.
Imagine how many eyes light up when you offer providers fewer logins, autopopulating forms, and uncluttered menus. There’s an assumption that technology, in the context of healthcare, has to be bad …
Why EMR companies don’t care about usability
During my sophomore year of college as a pre-med, I volunteered at the front desk of a free clinic, where it was typical to see patients waiting sometimes for more than two hours. At first I figured it was just because some patients took longer to examine than others. It wasn’t until I got certified as a nurse’s aide and started working in the medical department at the same clinic …
Using Google Docs to manage patients more efficiently
There was a hole in the wall of our bathroom that was a painful reminder of a bad encounter with a plumber. Yes, that hole has been there about a year, and it has been on my to d0 list for the duration, daring me to show if I inherited any of the fix it genes I got from my father. Why not hire someone to come fix it? I …
The ultimate DIY project: Create your own EMR
A guest column by the American College of Physicians, exclusive to KevinMD.com.
English is the international language of medicine, according to many. Regardless of whether that is true, what is becoming increasingly clear is that English is the second language of medical documentation. For those of you who blame EHRs for this, the replacement of English by something else started …
English is the second language of medical documentation
As a physician, I experience first-hand the impact that internal communication at a hospital—both good and bad—has on patient care.
If I am able to quickly access clinical systems, analyze patient information and collaborate with colleagues, I can diagnose and interact with the patient much more efficiently and effectively. Conversely, breakdowns and inefficiencies in the communications process can inhibit the delivery of quality patient care by bogging down workflows, creating delays …
The impact of outdated communications technologies in healthcare
I would like now to delve into what I consider critical elements of patient-centric care. They all involve technology to various extents.
1. There must be buy-in from providers. I am including payers, healthcare systems as well as clinical providers in this category. While I realize that much of healthcare is devoted to satisfying legal and regulatory mandates, there is great opportunity to improve the care experience (and dare I say …
5 critical elements of patient-centric care
A few months ago I wrote a post about the 159 page digital fax that I received, containing records for a patient’s recent lengthy hospitalization.
I’ve now discovered something even more time-consuming and annoying: a 202 page paper record mailed to me by a major medical system. (I won’t name names right now; suffice to say this system uses Read more…
My workflow for going through old paper charts
There are an estimated 15,000 medical apps presently on the market and is expected to grow 25% per year according to one study. There are issues which are common in the development of these apps and other categories of apps. However, some technical and non-technical issues are unique to the sector. As someone who does not design apps, …
5 reasons why mobile health apps fail
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