Health IT and AI in Medicine

Physicians writing on KevinMD about the electronic record and artificial intelligence: what the record did to the visit and who it was built for, alert fatigue and pajama time, human and AI scribes and the minutes they actually save, ambient documentation and its audit risk, and what AI can do in clinical practice now, whether it will replace physicians, 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.

What is the secret sauce to digital health?

John Nosta

Health Technology

November 24, 2014

I understand that for some, digital health still might be a bitter pill, but the promise of techno-medical mumbo jumbo is bold and transformative. That being said, in my opinion, the “secret sauce” to digital health might be a bit outside the conventional “drug development” methodology — both in logistics and psychology.

Therefore, I thought it would be fun to take a page out of IBM’s Watson playbook. IBM recently used “cognitive …

2014: The death of meaningful use?

Robert Wachter, MD

Health Technology

November 23, 2014

The policy known as meaningful use was designed to ensure that clinicians and hospitals actually used the computers they bought with the help of government subsidies. In the last few months, though, it has become clear that the policy is failing. Moreover, the federal office that administers it is losing leaders faster than American Idol is losing viewers.

Because I believe that meaningful use is now doing more harm than good, I see these …

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2014: The death of meaningful use?

Avoid these 4 mistakes when using a computer in the exam room

Richard Loomis, MD

Health Technology

November 21, 2014

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With the growing usage of EHRs, more and more doctors are bringing their computers and tablets with them into the exam room. But just because you’re using a computer in the exam room, it doesn’t mean that you’re using it properly. Computers can be one of the most beneficial tools you use in an exam room, or they can lead to …

Money for nothing: The dire straits of EHRs

Michael Chen, MD

Health Technology

November 20, 2014

I’ve previously written about my experience with poorly designed electronic health records and how it negatively impacts provider happiness and patient safety. Apparently, I’m not alone in my experiences and my sentiments about this subject.

First, we have a study that validates the concern that EHRs waste time for doctors. Imagine the impact for primary care physicians who are already crammed for time, seeing patients in short time intervals just to keep their overhead.

Then, …

Meaningful use: The independent majority can stop the madness

Margalit Gur-Arie

Health Technology

November 17, 2014

According to the American Medical Association, there were approximately 685,000 physicians in patient care, post-residency, not employed by the federal government, in 2012. 60 percent of these physicians practiced in independent private practice, and 84 percent were working in small to medium size practices. Assuming that the trend to employment of doctors by health systems continued unabated to this day, over half of practicing physicians are still in private practice and …

5 new rules for how doctors interact with health care IT

Suneel Dhand, MD

Health Technology

November 17, 2014

Information technology clearly has a long way to go before it delivers on the immense promise of technology to truly improve health care. Most of the current solutions — quickly rolled out in response to meaningful use requirements — are slow, inefficient and cumbersome.

Physicians (and nurses) spend far too much time staring at their screen and navigating the system, often to the detriment of patient care time. A study published last …

Communication is key between physicians and EHR programmers

Fred N. Pelzman, MD

Health Technology

November 16, 2014

It seems like every few days we get a message in the in-basket of our electronic health record (EHR) about a new type of message that we will be receiving in our in-basket.

They call these messages “system notices.”

OK, maybe that’s an exaggeration, maybe not every few days, but the different types of in-baskets and all the information we are bombarded with is getting out of control. As users of electronic …

Terrifying truths about health care IT

Varun Verma, MD

Health Technology

November 15, 2014

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One would expect that in an era where smartphones are more powerful than our computers were 5 years ago, health care providers would have an arsenal of health care IT solutions to enhance patient care but also optimize their own workflow.

Shockingly, in 2014 most health care IT solutions (such as EHR systems) are incapable of basic functions that we take for …

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Terrifying truths about health care IT

Building a better EMR. Read how one doctor is doing it.

Rob Lamberts, MD

Health Technology

November 11, 2014

The documentation I get from everyone is terrible. Seldom does it tell me what I actually want to know, and if there is useful information it is buried in an avalanche of yada yada. The main reason for this is that documentation is driven by our ridiculous payment system, which requires us to follow arcane rules to generate notes that justify the obscure codes we submit for money from the …

What’s your physician digital health innovator type?

Fard Johnmar

Health Technology

November 8, 2014

Where are all the physician digital health innovators?

This is a question I hear all the time from people working in, researching and observing the fast-moving health technology arena.

The general thinking is that physicians are not involved enough in digital health — and it shows. Over the past year, I’ve been making it a point to talk with people from around the world, including doctors, about their perceptions of digital health.

Physicians …

Apple Watch and HealthKit: A new age of virtual health care

Kevin R. Campbell, MD

Health Technology

November 8, 2014

The practice of medicine and health care in general has become an electronic and increasingly mobile interaction. Patients are better informed, more engaged, more connected and have a much greater virtual presence. In fact, according to Pew Research, the fastest growing demographic on Twitter are those who are in the 45 to 65 age bracket. Nearly 50 percent of all …

Your electronic health record may lack vital information

Linda Hertzberg, MD

Health Technology

November 7, 2014

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

When you walk into any physician’s office or hospital, computers are everywhere. By 2013, nearly 70 percent of hospitals had moved away from paper charts and toward electronic health records, or EHRs, and more are making …

Why EMRs won’t prevent the spread of Ebola

Matt Patterson, MD

Health Technology

November 4, 2014

According to IBM, there are 2.5 exabytes of data created every day, and most of it is unstructured. Imagine receiving all the words ever spoken by human beings on your doorstep each and every day. Now, imagine consuming that, making sense of it and trying to keep up with the ever-accelerating pace of data creation each day.

As a physician, I experienced firsthand the angst that comes with trying to keep up …

Transition of care: A letter to ACO General Hospital

Rob Lamberts, MD

Health Technology

November 2, 2014

Dear ACO General Hospital:

Thanks for contacting me about my most recent blog post. I’m sorry to scare your administration about HIPAA information, but I am equally concerned about that and will always do my best to respect the privacy of my patients. At your request I hid even more of that information.

I know it’s kind of embarrassing to have that kind of thing made public, and I am overall …

Why is medical IT so bad?

James C. Salwitz, MD

Health Technology

November 1, 2014

A 57-year-old doctor I know is retiring to teach at a local junior college. He is respected, enjoys practicing medicine and is beloved by his patients; therefore, I was surprised. While he is frustrated by the complexity of health insurance, tired by the long hours and angered by defensive medicine, the final straw is that he can not stand the world …

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Why is medical IT so bad?

Do EMRs improve patient safety? A debate.

Karen S. Sibert, MD

Health Technology

October 30, 2014

“I’m here to say ‘Yes, they can,’ which is different from ‘Yes, they always do,’” says James Moore, MD, president-elect of the California Society of Anesthesiologists (CSA).

To the contrary, enthusiasm for electronic medical records (EHRs) is part of a “syndrome of inappropriate overconfidence in computing,” argues Christine Doyle, MD, the CSA’s Speaker of the House.

The two physician anesthesiologists (and self-identified “computer …

5 ways to increase your EMR efficiency

Brian Anderson, MD

Health Technology

October 28, 2014

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 …

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5 ways to increase your EMR efficiency

Ebola forces us to rethink how we document in the EMR

John Halamka, MD

Health Technology

October 26, 2014

Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination.

One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and …

5 reasons why physician champions are needed

David Lee Scher, MD

Health Technology

October 25, 2014

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 …

Dissociate EMRs from billing. Here’s how to do it.

David Mann, MD

Health Technology

October 24, 2014

The idea of starting over with computerized electronic health record (EHR) systems and doing them right as mentioned in a previous post has struck a resonant chord. Unfortunately designing an EHR that works may be a fantasy, due to one huge hurdle that would have to be overcome first. But it is fun to imagine an alternative universe where EHR systems were patient-centric instead of …

Health IT and AI in Medicine

Health IT and AI in Medicine

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