Ironically, the same electronic health records (EHRs) initially designed as a tool to help physicians diagnose diseases have largely evaded diagnostic scrutiny. Talk to physicians who utilize them on a daily basis, however, and it becomes abundantly clear that today’s EHRs are ailing. They are adding hours to the physicians’ workday, siphoning attention from patient care, and sowing the seeds of demoralization across the profession of medicine. To address this …
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The impaired interactivity of EHRs
I’d be willing to bet most of you have heard of, or previously used, telemedicine in some shape, form or fashion. Stated simply, telemedicine is the process of seeking care from a medical provider using your phone or laptop. This field is exploding, and I have no doubt popularity will continue to grow as large health systems and pharmacy giants dive in.
It’s easy to appreciate the convenience and efficiency of …
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Beware the limits of telemedicine
We all have that one patient. That one patient who can always find a way to turn a good day bad, who just knows how to push your buttons in all the wrong ways.
Who’s that patient for me? Let’s just call him Elton Reed.
Oh, Mr. Reed … where to begin with him?
When we first met, I remember being so excited and energized by him. He just had this fresh feeling …
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The one patient that drives physicians to burnout
The trouble began when I needed to open the electronic health record (EHR) system for the tenth time that day. EHRs have significantly changed the way we practice medicine. They have completely eliminated the need for storage and transport of paper charts, reduced prescription errors secondary to illegible handwritings of physicians and provided an excellent platform to maximize billing for services rendered. However, in terms of creating a smooth workflow …
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I didn’t become a physician to do data entry
Fake news is a term that’s become notorious over the last couple of years. For notorious reasons perhaps. But there’s actually another serious arena where there is inadvertently an awful lot of “fake news” on a daily basis. And that is, well you guessed it: in health care throughout our nation’s hospitals and offices!
Let me explain, and I suspect anyone who works in health care will be familiar with the scenario. …
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The best way to fight misinformation in health care
Technology can be both a blessing and a curse and nowhere is this more painfully evident than in the U.S. health care system. If technology is to be used to improve the patient-doctor relationship, its systems should be designed by physicians who understand these needs, not by regulators and health care conglomerates for whom business objectives are paramount. When it’s all about billing and meeting documentation checkboxes and hospital requirements, …
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Technology ought to save lives. So why aren’t we using it better?
How smart do we want our electronic health record to be?
Somewhere between as dumb as a piece of paper and a pen, and too smart for our own good.
Many, many years ago, before we spent the majority of our office visit staring at a flatscreen LED and typing away, our charts were simple manila folders with those bendy metal bars that allowed you to insert new pages, separated into multiple …
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Love smart functions in your EMR? This doctor doesn’t.
Drivers are distracted klutzes and computers could obviously do better. Self-driving cars will make all of us safer on he road.
Doctors have spotty knowledge and keep illegible records. EMRs with decision support will improve the quality of healthcare.
The parallels are obvious. And so far the outcomes are disappointing on both fronts of our new war against human error.
I remember vividly flunking my first driving test in Sweden. It was early …
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How today’s EMRs are like self-driving cars
Wouldn’t it be cool if … ?
Wouldn’t it be better if … ?
Wouldn’t it be much easier when we see patients if … ?
How come we can’t … ?
It seems like every day, someone in our practice comes up with an idea for a way to do something better:
- From our front desk staff who check patients in, and have to deal with a multitude of electronic systems for registration, …
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How did EHR designers get control of health care?
Physicians do not have a lot of power these days. But if you know when, where and how to look, we can, on occasion, score some victories.
Case in point: hospital bylaws that every physician is required to acknowledge and sign before being granted privileges. It is always a good idea to carefully read before signing anything, and I did the just that before signing my hospital’s bylaws. I asked a …
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Hospital bylaws saved this doctor from EMR burnout
Blockchain technology has the potential to dramatically transform health care delivery by facilitating data exchange between providers and electronic health record (EHR) systems. A decentralized and transparent platform, blockchain technology provides an authenticated platform that applies a consensus-driven approach to facilitate the interaction of multiple entities through a shared ledger. For the health care sphere, blockchain is simply the sharing of medical information through EHRs across numerous hospital systems that …
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Blockchain technology can dramatically transform health care delivery
Physician burnout is increasing at an alarming rate. According to a January 2017 AMA Wire report, physician burnout rate has increased from 2013 to 2017 across every specialty in medicine. Greater than 50 percent of primary care providers are burned out. Therefore, every patient at the entry point of medical care is, more likely than not, going to be treated by a burned out physician. The question is why are …
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A relatively simple solution to physician burnout
I was a foreign medical graduate who in addition to some clinical practice, had begun a career first in managed care as a utilization management coordinator and then as a clinical researcher after finishing medical school and then pursuing a public health degree.
A few years ago, life took some unexpected turns, and I found myself in a rather new field of health care known as clinical documentation improvement (CDI). I …
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Is this a medical miracle or a medical error in documentation?
Physicians have a love-hate relationship with the electronic health record (EHR). On the one hand, doctors know they can’t provide the best possible medical care without them. And on the other, today’s EHR systems are cumbersome, clunky and slow physicians down.
Indeed, there’s much to love and much to hate about today’s EHRs, alongside a variety of ways to address the problems they create. One solution may lie in blockchain, the technology currently …
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Why blockchain technology might replace today’s EHRs
Eons ago, there was a television show where a non-human character would yell out, “Warning, warning,” when he sensed imminent danger. The series was called Lost in Space where we were entertained by a set of quirky characters on a cheesy set. We loved that stuff. It’s hard to imagine today’s millennials and younger folks being transfixed, as we were, with the deep television dramas of our day. Who could …
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The intensity of EMR warnings: Who do they really help?
I can’t help myself from telling patients how things really work in health care. But I feel they have a right to know.
When I see new patients their jaw usually drops when I sit down with them next to the computer with a stack of papers held together with a rubber band or a gigantic clamp and with yellow sticky notes protruding here and there with words like LAB, ER, …
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Betamax or VHS: EMRs are 100 times worse
It is all too common for a section in a progress note to look something like this:
# Aspiration pneumonia:
- Continue vancomycin 1 g bid
- Continue Zosyn 3.325 g q6h
- Follow-up blood cultures
- Follow-up sputum cultures
- MRSA nares screen negative
- Blood cultures negative
- Discontinue vancomycin
Yesterday, a version of this note (lines 1 to 5 to be precise) had my name on it. Today, it is signed by someone else. Read it …
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Clinical plagiarism: the problem of copy and pasting in EMRs
At the start of the transition to electronic health records (EHRs), I was totally on board as one would expect of a millennial doctor. I, along with my fellow millennials, grew up alongside the internet. We can type with our eyes closed, navigate pop-ups in a jiffy and intuitively know how to manipulate electronic charts to serve our purposes.
But, I did find myself in a unique position in the millennial …
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A millennial doctor’s love-hate relationship with EHRs
