It is no news a lot of doctors like to stick up a rather snotty nose to EMR. The defenders of the EMR tend to label such doctors as archetypal Luddites, sticking to their archaic ways and unbecoming of change and the new times. But as is usually the case with any two heated but opposite arguments, the truth likely lies …
Explaining the epic failure of EMRs
Insurers will also play a pivotal role in the development and adoption of patient-focused mobile health (mHealth) technology adoption for wellness as well as for the management of chronic diseases.
1. Payers hold the purse strings. Insurers will be the ones paying for the use of mHealth for chronic disease management for the vast majority of patients. They have a vested interest …
Mobile health technology adoption depends on insurers
Warning! I am a practicing doctor who sees real patients using an electronic medical record (EMR). My sole agenda is to provide the best patient care. I have no financial stake in information technology (IT). However, unlike the editorial board at the Wall Street Journal, Mr. Stephen Soumerai of Harvard or Mr. Ross Koppel of the University of Pennsylvania, I have actually …
Why IT is the core of the healthcare renaissance
I was skeptical about the iPad Mini. I’ve used my Retina display iPad (3rd generation) for the past six months and been satisfied with the experience.
I’ve used it in the hospital setting during rounds, and even while talking to patients in the ER. I’m able to easily pull up Epic’s EMR using the Citrix app, and I can easily store the iPad …
Why the iPad Mini is the tablet physicians have been waiting for
I have a lovely pen. It’s a Mont Blanc Meisterstück fountain pen. My group bought it for me on my tenth anniversary as a partner in our emergency medicine practice.
It’s a luxury I would never have paid for myself, though I have loved and used fountain pens since I was in college. Ironically, about the time I got it, the window …
My experience with a scribe in the emergency department
I can’t stop thinking about a drive-thru. Not the one for burgers and shakes but the one for ear checks, sports forms, quick med refill visits or a lingering rash. For those things you just want to know fast or need done now, but don’t want to spend 2 hours resolving. For those things that really make you worry as a parent. Instead of the millisecond-mall-type clinic, we all want …
Physicians must innovate to meet the needs of patients
Every time someone publishes an article or a paper or a blog post that has anything remotely to do with electronic health records (EHR), there is usually a flurry of reactions in the comments section, now available in most publications, and these always include at least half a dozen anonymous statements, usually from clinicians, decrying the current state of EHR software, best summed up by a commenter on THCB: “It …
The EHR user interface and my personal moment of Zen
You’re using an EHR. You’re e-prescribing. You’ve eliminated pulling the old paper chart (most of the time!). That’s good.
But how about those orders?
Are you still writing on the bottom of your fee slip or encounter ticket that you want the patient to be scheduled for a test or with another physician? That’s not good.
Get the order in your EHR.
Instead of taking the time to write on paper, keep your hand …
Getting your orders online reduces risk in the practice
Click, click, click, “Hello, how are you today?”
Click, click, click, “How long have you had a sore throat?”
Click, click, click, “Have you had a fever?”
Click, click, click, “Have a seat on my exam table, please.”
Click, click, click, welcome to my day. Let me introduce myself, I’m a professional clicker. I used to be a member of a highly respected and sought after profession; a doctor. The modern world of government/insurer …
Click, click, click: How can I help you today?
In a recent New York Times article, “Redefining Medicine with Apps and iPads,” Katie Hafner describes a “generational divide” in medicine. On one side sits the younger generation, at ease navigating EMRs and diagnosing disease with the assistance if digital apps. On the other side of this presumed generational divide, she describes the older generation, worried “that the human connections that lie at the core of medical practice …
Does the use of digital medicine preclude human connection?
Venture capitalists (VCs) … are a combination of professional gamblers and loan sharks. The secret to success is pure luck and ruthlessness, and when the combination works and the ball lands on the exact number on the spinning roulette, venture capitalists make lots of money.
-Margalit Gur-Arie, via KevinMD.com
The tone of this article, Why venture capitalists shouldn’t try to solve health care, exemplifies what is wrong with healthcare. In …
Why the VCs aren’t the bad guys
Imagine this scenario: A CEO stands in front of the board at a crucial juncture in corporate history, and says:
Members of the board, as you can see from the financial statements before you, we have had a reasonably good year. What!? You don’t have the financial statements in front of you? I have them here. I mean, I think I have them here. Where are they? Let me check with …
We need a functional health information exchange
Healthcare innovation companies are just beginning to understand technology challenges that come with engaging patients with chronic diseases in care management and care transition. Many of healthcare IT vendors assumed that a simple access to portals with half-baked information and fragmented medical records will do the trick. Boy… were they wrong!
For the past twenty years, the HIT industry has focused on developing software solutions exclusively for healthcare providers. These companies …
Without patient participation, there is no patient engagement
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I work at several hospitals and each uses a different electronic medical record system. When I switch from hospital one to another, I obviously have my favorite EMR systems and my not so favorite EMR systems. In the previous post, I was using the EMPOWER charting system, which I liked for its simplicity, but disliked because of the layouts of the charting interface and some of the macros it contained.
After …
More than half of my ER shift was spent on entering data
“This note was produced using [mega-brand] medical dictation software. While every effort has been made to insure accuracy, errors may still exist.”
Really? What kind of doctor would admit in a medical chart to being too lazy or incompetent to produce an accurate record?
A lot of them. Dictations are easy to read if you are willing to confound legibility and accuracy. Dictation software is relatively cheap, and with the continued profusion …
If pilots worked like doctors, the sky would rain planes
As medicine moves forward in its most technologically advanced era yet, we continue to struggle with basic concepts such as record keeping. The medical record is vital to the care of the patient. It tells the story of each patient’s journey through the medical system. The idea of centralizing all pertinent medical information is, in theory, a step in the right direction. In utopia, there would be one medical record …
What are the biggest issues with EMR today?
Not long ago, Secretary of Health and Human Services Sibelius and US Attorney General Holder issued a stern warning to healthcare providers who are using electronic health records (EHRs). The federal officers maintain there has been an alarming increase in the charges to Medicare in institutions where EHRs have been implemented, and they warn that those behaviors will be treated as “fraud,” an illegal gaming of the system to increase …
Using the F-word when it comes to EHRs
Does your doctor use a computer instead of a paper chart?
Chances are that she does. The rate of adoption of electronic medical records (EMRs) over the last three years has been very steep.
The main driver of this is a government subsidy from a part of the 2009 Stimulus Act (called the HITECH Act) that incentivizes doctors and hospitals to make the conversion to electronic record-keeping.
The push has …
The fine line between gaming the system and maximizing documentation
The electronic medical record (EMR) is here to stay. Its adoption was initially slow, but over the past decade those hospitals that do not already have it are making plans for implementing it. On the whole this is a good thing because the EMR has the ability greatly to improve patient care. Physicians, as well as all other caregivers, no longer have to puzzle over too often barely legible handwritten …
The EMR is trying to serve too many masters
Vendors talk about partnering with medical practices all the time – especially in the information technology (IT) world of electronic health records (EHRs) and practice management systems. But, ask any physician about their IT solution and most will express dissatisfaction, unhappiness, or harsh complaints.
The reason? For the most part, medical groups are not trained effectively for integrating IT into their work flow.
Ask EHR vendors about their approach to training and …
Make IT vendors your partner for a smooth EMR transition
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