I recently sat in a small room, in the bowels of a local hospital, training for the impending implementation of CPOE. For those not familiar with current health care acronyms, this stand for Computerized Physician Order Entry.
Nearing the end of my medical career, I could not help but admire the timing of this phenomenon. “They’ve finally done it,” I mused silently. They …
How the physician replaced the medical secretary
I found out this past weekend that the VA will be making clinician progress notes available for patients to view on the MyHealtheVet portal. In other words, the VA is going OpenNotes. (Note: I was a primary care provider in geriatrics clinic at the San Francisco VA from 2006-2010.)
My first reaction was to be impressed by this bold progressive move.
My next reaction was to …
OpenNotes in geriatrics: 6 awkward concerns
Better Care for Individuals, Better Health for Populations, and Lower Per Capita Costs
–ihi.org
If you stop to think about the holy grail of health care reform, also known as the Triple Aim, it sounds like a grand challenge involving wizardry or wishful thinking or worse, propaganda for the masses, particularly the last part. It’s like attempting to build a better driving machine, with better fuel efficiency at lower cost. …
How pushing the Triple Aim ignores doctors and their patients
Health information technology (HIT) has had a tremendous – and mostly positive — impact on our systems for recording, delivering, monitoring, and reporting the healthcare and services we deliver.
Like most of my colleagues, I can tick off at least five or six large “pioneer” corporations – companies like Epic, Cerner, Allscripts, Siemens – in the forefront of the technology explosion that yielded …
Doctors lack an analytic engine: Why we need EMR 3.0
For practicing physicians, there’s a tricky balance in believing that the Internet can help save lives.
I’m a doctor who encourages families to look up health info online and one who believes technology will afford improved partnerships. Yet, when we’re in the old-fashioned exam room, there isn’t always a place for the Internet. Many clinics block video-streaming sites and don’t allow for traditional email …
Dr. Google: Tips for patients who diagnose online
I have long been a proponent of proven technology in the digital health space. Probably the most obvious reason is to dispel the generalized notion that these technologies are flimsy. The HHS Text4HealthTask Force has endorsed clinical studies in its recommendations. There certainly have been studies performed. One interesting one, the final report of The National Mobile Health Worker Project of the …
5 reasons why mobile technology needs clinical trials
The implementation of the electronic medical record (EMR) in American medicine gained a powerful foothold in medical care with the passage of the American Reinvestment and Recovery Act (ARRA) in 2009. With the passage of this act came the promise of improved efficiencies, safety and ultimately reduced cost delivery for health care. Also, some $18 billion dollars in financial incentives were offered to physicians …
The ethics of EMR: How unproven technology affects patients
Adam Smith would disagree, Karl Marx would be appalled, and heck even Milton Friedman and Ayn Rand would be raising objections. But for some peculiar reason, there are enough contemporary lesser economic minds scattered throughout the entire philosophical spectrum, that are advocating for, and enabling the execution of, a government induced transition of our health care system to an oligopoly model …
Is consolidation the answer to healthcare’s fragmentation problem?
Should physicians use a consultant to help choose a practice management system or EHR for their practice? According to recent Medical Group Management Association surveys more than 50% of physicians used the services of a healthcare consultant or firm at least once in the previous 3 years.
But did they have to? Was it a smart move?
The answer: It depends
Not every practice needs a consultant’s assistance when replacing and choosing …
When should physicians hire an IT consultant?
On my birthday several weeks ago, I was lucky to get an iPad Mini from my husband. I already have an iPad and have shared my experience. In fact, we gave all of our residents iPads (one of them contacted Steve Jobs and got a response), and documented an improvement in efficiency on the wards. So why the Mini? What is …
Using the iPad Mini in the hospital: One doctor’s experience
Wikipedia defines patient portals as “… healthcare-related online applications that allow patients to interact and communicate with their healthcare providers. Some patient portal applications exist as stand-alone websites and sell their services to healthcare providers. Other portal applications are integrated into the existing web site of a healthcare provider. Still others are modules added onto an existing electronic medical record system. What all of these services …
Do patient portals increase patient engagement?
Happy New Year! It’s 2013! Time for us to embark on ambitious health and fitness resolutions we have no intention of keeping past March!
Here to assist us with our resolutions are a collection of fitness devices and apps that will help track our heart rate, sleep cycles, calories burned, steps walked, mood and much more. Data from these devices can …
Patients who self track their data: Curb your enthusiasm
”Email is the killer app of patient portals.”
I heard a variation of that quote when interviewing people for the patient-provider communication chapter of the book I’ve been co-editing and writing for HIMSS with Jan Oldenburg, Brad Tritle and Kate Christensen. For the organizations who’ve pushed patient portals the furthest into their patient base, email is always the place where things started. In other words, email is the gateway drug for …
How secure messaging and email benefit patients and improve outcomes
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A recent New York Times headline read that “Medicare Is Faulted on Shift to Electronic Records.” The story describes an Office of Inspector General (OIG) report, released November 29, 2012, that faults the Centers for Medicare and Medicaid Services (CMS) for not providing adequate oversight of the Meaningful Use incentive program. Going after “waste, fraud, and abuse” always makes good headlines, but in this case, the story is …
Trust but verify: Medicare’s approach to detecting EMR fraud
If this were a business concerned with bottom lines, cash flows and sustainability, this would be a good time to begin planning one of those posh executive retreats to evaluate current strategy. People would be feverishly working on pulling data for PowerPoint presentations, summarizing market research and deciding whether to select the vegetarian meal or not. If this were a better …
Computers are meaningless in health care without computable data
Which of the following events is most traumatic for a practicing physician?
Unlike EMRs, paper charts never crash
My wife Elaine was hospitalized for 6 days recently with an array of ailments related to her advancing cancer, so diagnosing and addressing her problems required a multidisciplinary approach. In addition to the nursing and support staffs, she was tended by an emergency physician, two hospitalists, three gastroenterologists, a pulmonologist, an infectious disease physician and an interventional radiologist. With the exception of one specialist who had performed a procedure on …
Health information exchange is the foundation of care coordination
As physicians, we know that no matter what care we provide, Medicare and private payers are going to do what they can to reduce payouts. For the health of the nation, healthcare spending simply cannot continue on its current trajectory. Reform measures such as accountable care organizations, bundled payments and penalties for potentially preventable complications and readmissions may help reduce expenditures, …
Protect yourself against fraudulent EHR documentation
There has been an explosion in health apps. Patients are using them for weight loss, calorie counting, exercise monitoring, ovulation calculation and for many other health needs. But to truly integrate the concept of health apps in the health care system healthcare providers will need to get involved. There is discussion in the health IT world lately regarding physician adoption of …
Will doctors recommend health apps to patients?
I have used the electronic medical record (specifically EPIC) since 2004. I have grown accustomed to its nuances, benefits and quirks. There are parts about it I really like. There are parts of it I’d like to do without but accept that they are necessary evils in our current health care climate. I know that there will always be parts of any modified …
Information overload for doctors increases malpractice risk
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