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.

Public and private cloud computing at a hospital

Health Technology
July 15, 2011

In a meeting with senior management at Harvard Medical School, one of our leaders asked, “What is our cloud strategy?”

My answer to this is simple.   The public cloud (defined as the rapid provisioning and de-provisioning of CPU cycles, software licenses, and storage) is good for many things, such as web hosting or non-critical applications that do not contain patient or confidential information.

At Harvard Medical …

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Public and private cloud computing at a hospital

How might we think about EHRs globally while acting locally?

Health Technology
July 6, 2011

American health care information technology is undergoing two enormous leaps.

First, it is moving onto Web-based and mobile platforms – which are less expensive and facilitate information exchange – and away from client-server enterprise-centric technologies, which are more expensive and have limited interoperability. In addition, more EHR development activity is headed into the cloud, driven by large consumer-based firms with the technological depth to take it there. Both these trends …

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How might we think about EHRs globally while acting locally?

Medicine and the examples of unintended effects of technology

Health Technology
July 3, 2011

The interaction of humans and technology will always be unpredictable.  A few months ago this thought was driven home to me in a rather malodorous manner.

I have obstructive sleep apnea (OSA) and use a CPAP machine every night to sleep comfortably.  With OSA your airway collapses when you fall asleep.  A CPAP machine is a small technological marvel, quietly delivering heated, humidified air under gentle pressure through a …

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Medicine and the examples of unintended effects of technology

Online physician access is key to future patient communications

Health Technology
June 30, 2011

Imagine using Skype to contact your physician for a consult.

In the midst of this rapidly progressing technologic era, our delivery of medical services is being transformed by health information technology (HIT), electronic medical records (EMR), and advanced telecommunications.  In meeting criteria for “meaningful use,” physicians are driven to use these technologies to empower patients with communication through electronic medical records.  A primary goal is to allow patients to …

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Online physician access is key to future patient communications

Google Health failed because consumers did not see the value of a PHR

Health Technology
June 29, 2011

To measure is to know.

-Lord Kelvin

If you can not measure it, you can not improve it.
-Lord Kelvin

Versus:

Asking science to explain life and vital matters is equivalent to asking a grammarian to explain poetry.
-Nassim Nicholas Taleb

Technology is at its best when it is invisible.
-Nassim Nicholas Taleb

How can technology help us live healthier lives? Why did Google Health fail? Why are Klout and Twitter Grader publicly issuing a number to me …

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Google Health failed because consumers did not see the value of a PHR

One more thing: Works for Apple, but killed Google Health

KevinMD
June 27, 2011

Google Health is dead.

There have been plenty of post-mortems as to why, ranging from the fact that it’s not social enough (uh … no), to the realization that only a minority of practices have electronic medical records, yet alone a patient portal that can incorporate PHRs like Google Health.

I’ll chip in with my own reason — it suffered from “one more thing” syndrome.

PHRs today aren’t seamlessly incorporated into …

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One more thing: Works for Apple, but killed Google Health

The difference between an ambulatory and hospital EHR

Health Technology
June 19, 2011

What difference is there between an inpatient EHR and an ambulatory EHR?

The difference is quite significant, actually. Let’s start by looking a little deeper into hospital IT issues, and the evolution of tools that try to address them.

The hospital EHR environment

 

Traditionally, from an IT perspective, a hospital is not really a single system – it is a collection of systems in various departments.

Over the past few decades, each …

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The difference between an ambulatory and hospital EHR

How social media will merge with electronic medical records

Social Media in Medicine
June 17, 2011

Bryan Vartabedian, MD blogs at 33 Charts about the convergence of medicine and social media.  A post last year gives a vision of how current social media concepts will merge with existing electronic medical record (EMR) technologies to produce a fully integrated communications system for health professionals.

The picture Dr. Vartabedian paints is a dream for those of us who extensively use technology in other parts …

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How social media will merge with electronic medical records

How technology intersects with medicine and its impact on patients

Health Technology
June 15, 2011

by Alison McKnight

We are surrounded by technology. No matter where you go, you will find technology rearing its face, whether ugly and ungodly or tempting and beautiful. These advances have brought both good and evil to many professions, especially healthcare.

Twenty years ago, you would not have found signs instructing people to turn off their cell phones in physician offices. Now these signs litter both …

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How technology intersects with medicine and its impact on patients

Hospital inefficiencies observed during a surgery rotation

Health Technology
June 14, 2011

by Anar Mikailov

I recently finished my surgery rotation at a Level 1 Trauma Hospital in Philadelphia and amidst the ephemeral eight weeks I quickly realized the immense demands of a surgical residency. So, as an avid technology enthusiast and a team member, I took note of inefficient workflows with potential for technology driven solutions. By discussing the observed inefficiencies and potential solutions I hope …

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Hospital inefficiencies observed during a surgery rotation

Securing mobile devices in healthcare

Health Technology
June 11, 2011

by David Ting

With the mobile market exploding, healthcare IT administrators are now faced with physicians and other clinicians requesting to use their personal devices, such as iPads and iPhones, to access patient information from anywhere, anytime.

With this ability, clinicians are able to make faster decisions for their patients – improving their overall workflow and patient outcomes. This seductive mobile technology, however, is not …

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Securing mobile devices in healthcare

How shopping for an EHR is like buying a car

Health Technology
June 10, 2011

So you’ve been hearing all about the recent EHR buzz and decided to give it a try.

Whether you are convinced that electronic records are the way to go, or you have reached a point where you are willing to give it a try, the first thing to do is buy one of those EHRs. You may be staring at a glossy brochure or website featuring a distinguished silver-haired doctor …

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How shopping for an EHR is like buying a car

How robots will teach us who we are as humans

Health Technology
June 10, 2011

Recently, I took a Megabus from Philadelphia to Hunter College in New York City to attend Man-Made Minds: Living With Thinking Machines, a World Science Festival program.

Rodney Brooks, who until recently was Panasonic Professor of Robotics at MIT and who now is Chief Technology Officer at Heartland Robotics, was the first expert to speak, and he emphasized a very practical approach that was not too concerned with any negative consequences …

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How robots will teach us who we are as humans

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Work should be about optimizing your productivity and health

Patient
June 1, 2011

Do you spend 8 hours in front of a screen at work? Do you then spend your free time watching TV or poking around the internet when you get home? How much time are you spending cooking healthy meals to eat with friends and family? How much time are you doing physical activities that make you happy?

A recent study in the Journal of the American College of Cardiology entitled, Screen-Based …

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Work should be about optimizing your productivity and health

Questions to ask before moving from a paper chart to an EHR

Health Technology
May 31, 2011

The transition from paper to EHR is a major policy decision that can have repercussions on patient service, your operations and even your medical professional liability (MPL).

Unfortunately, many practices are not taking the time to analyze their options and responsibilities from a patient care and compliance standpoint.  In order to set the correct framework for your effort, you should think …

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Questions to ask before moving from a paper chart to an EHR

How the VA looks at population level data to analyze outcomes

Health Technology
May 30, 2011

The VA isn’t perfect, but definitely is better than other health care systems I have worked in so far.  It embraces the idea of patient-centered medical home, where a primary care physician coordinates and takes responsibility for a patient’s care … the old-school definition of good medical care that has recently become popular again, …

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How the VA looks at population level data to analyze outcomes

Will an Android or iPad platform dominate hospitals?

Health Technology
May 24, 2011

Felasfa Wodajo, MD has written a post for iMedicalApps on the iPad’s future role in healthcare institutions. The title says it all: Why Locked Android Tablets Will Beat the iPad for Hospital Use.

The gist of his argument is that Android’s “openness” and hardware-agnosticism will make it more ubiquitous in the market in general, and a more robust and …

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Will an Android or iPad platform dominate hospitals?

Pros and cons of cloud based or web based EMR systems

Health Technology
May 18, 2011

As if medical practices don’t have enough to worry about with EMR implementation, now they have to decide what kind of EMR system to get: a client-server-based system or a web-based system. The former is the kind that most of us are familiar with. You purchase a computer server, buy a license for the EMR software, install said software on your server, …

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Pros and cons of cloud based or web based EMR systems

5 things I learned from a MD inventor and serial entrepreneur

Physician
May 17, 2011

by Ashwin Patel

As a MD/PhD candidate, I enjoy learning how medicine interfaces with other fields. I found that MDs that have ventured into these fields have the best stories and insights to share.

I recently had the privilege of interviewing Dr. David E. Albert, MD. He’s a physician, a successful inventor with 30+ patents, and a serial entrepreneur. He has sold two of his companies, one to …

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5 things I learned from a MD inventor and serial entrepreneur

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