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 meaningful use stage 1 will mean to patients

John Halamka, MD

Health Technology

December 11, 2010

As State Health Information Exchanges and Federal efforts (NHIN Connect/NHIN Direct) implement the data sharing technology that will enable all providers in the country to achieve Meaningful Use Stage 1, I’m often asked “but when will this healthcare information exchange technology be able to retrieve all my records from everywhere when I’m lying unconscious in the Emergency Department and cannot give a history?”

Here are …

Health IT and doctors need to bridge the cultural gap

Mike Koriwchak, MD

Health Technology

December 9, 2010

The recent financial incentives offered by the government (HITECH) for EMR implementation are somewhat helpful but are also misleading.

Most fail to recognize that the biggest obstacles to EMR implementation are not financial, but are cultural. EMR adoption will require cooperation between two disparate cultures: the Health IT (HIT) culture and the medical culture. One needs only to read a few of the EMR debates in any health care blog to …

The internet and online health information trends

Susannah Fox

Patient

December 8, 2010

Ten years ago, I wrote the Pew Internet Project’s first report on the impact of the internet on health care, calling it “The Online Health Care Revolution.”

Back then, the idea that people were searching online for health information was revolutionary. All of a sudden, regular people had access to medical information that had always been locked up and out of reach.

Ten years later, I am ready to declare the access …

A better system is needed to migrate to electronic health records

Steven Reznick, MD

Health Technology

December 2, 2010

Five years ago my associate and I invested sixty thousand dollars to purchase and set up an electronic health record system and eliminate extensive paper use.

We researched all available systems and decided upon MediNotes because it was a large company with an excellent record of service and their system met all the national requirements for certification. We worked through our local computer vendor’s family …

Electronic health records (EHR) to improve medication compliance

Robert Rowley, MD

Health Technology

November 29, 2010

A recent report in the Annals of Internal Medicine on the characteristics of prescriptions that are abandoned at the pharmacy raise the question of (1) how to ensure that people actually pick up their prescriptions, and (2) how to make sure that people actually take the medications that are prescribed.

What role does modern Electronic Health Record (EHR) technology play in this question?

A study by the non-profit New England Healthcare Institute …

Scribes lead to unintended consequences from electronic medical records

Douglas Perednia, MD

Health Technology

November 29, 2010

Recently, Dr. Scot Silverstein over at Health Care Renewal published this update to the ongoing story of electronic medical records that are so simple, intuitive and easy to use that doctors and hospitals everywhere are being forced to hire “scribes” to run them.

We’d looked at the resurgence of scribes in a previous post, and Dr. Silverstein’s article seems to confirm that the phenomenon is is here to stay …

How small private practices can still thrive

Susan Giurleo, PhD

Physician

November 26, 2010

Health care is changing at lighting speed. If you don’t know this, or worse, don’t accept it you’re doomed. No. Really. It’s change or close shop. Whether you like it or not, health care reform is going to change the way we practice from now on.

Many physicians are choosing to work for large group practices to buffer themselves from directly dealing with change. Mental health providers could do the same, …

Trust your life records to an unnamed chain of software vendors

Margalit Gur-Arie

Health Technology

November 21, 2010

Every day millions of Americans and billions of people around the globe are routinely accepting colorful pieces of paper in return for their labor and placing those hard earned possessions in modern glass buildings whose owners they do not know.

It took a few hundred years to change how business transactions are conducted, but today, there is very little apprehension about depositing one’s wealth in a bank. Public trust in both …

Why EHRs aren’t meaningful to doctors and hospitals

Richard Reece, MD

Health Technology

November 18, 2010

Electronic health record (EHR) advocates in Washington don’t seem to get it. They don’t seem to understand that hospitals and doctors aren’t rushing to install EHRs because many EHRs, despite the constant talk that EHRs are a prerequisite for good care. Caregivers are not walking the talk, because in their view, EHRs,

aren’t ready for prime time
slow productivity
decrease revenues,
show scant returns on investment
don’t talk to one …
Read more…

Why EHRs aren’t meaningful to doctors and hospitals

EMR is here to stay, which will be good for doctors and patients

Christopher Johnson, MD

Health Technology

November 17, 2010

The electronic medical record, the EMR, is upon us.

For those of us who learned medicine entirely with paper charts, some have enthusiastically embraced the EMR and some have refused, to the extent they can, to deal with it at all. But most of us have plowed ahead into learning how to use it as best we can. It seems to me that the degree of enthusiasm physicians show for the …

Understand your options before monitoring Internet use

Peter J. Polack, MD

Health Technology

November 10, 2010

As medical practices become more advanced, staff members gain improved access to the Internet during work hours. Cyber-slacking is a well-known problem in corporations; in fact, one study found that over thirty-five percent of employees admit to using the Internet for personal surfing at work.

The New York Times cited that twenty-five percent of Net use on work computers isn’t actually work-related. Although it is unknown how severe the problem is …

How EMRs are failing nurses

Jared Sinclair, RN

Health Technology

November 9, 2010

Among the litany of complaints about the (un)usability of EMRs, it’s easy to lose sight of the big picture. More than the poor design choices and overall ugliness of existing software, by far the single biggest failure of HIT companies is that none of them has yet to produce an EMR that nurses actually need.

There is a huge opportunity being wasted here. Other industries have been able to incorporate computers …

Read more…

How EMRs are failing nurses

Patient safety suffers when doctors are forced to learn multiple EMRs

angienadia, MD

Health Technology

November 9, 2010

As a new intern at a well-endowed medical institution, I was disappointed despite the flurry of excitement that comes with orientation. I was disappointed despite the brand new privilege to save lives and relieve human sufferings. And the disappointment was made clear to me over the past two days.

What has happened in the past two days? As I will be working at two separate hospitals, for the past two days …

Physicians should establish rules with their patients before using a PHR

Glenn Laffel, MD, PhD

Health Technology

November 5, 2010

These days, it seems that for every consumer advocate out there who promotes the personal health record (PHR) as The Patient Empowerment Ubertool, there’s at least 10 physicians worried sick that the technology will further complicate their frazzled work lives.

The fear and loathing derives from an increasingly common and distinctly distasteful experience in which a patient presents the physician with a thumb-drive, computer disk or Web-link to a site containing …

How health care could benefit if a company followed Apple

David Ahn, MD

Health Technology

October 30, 2010

Health care workers throughout the country daily face the growing pains of the transition from paper charts to electronic medical systems. Not only are there frustrations within each system, every hospital seems to have selected a different EMR. When I was a medical student at UCSD, I was exposed to 4 separate EMR’s (Epic, PCIS, CPRS, Centricity, etc) during my rotations at various San Diego hospitals.

In this Wild West era …

Physician email implementation inertia

Kevin

Physician

October 29, 2010

by Jon Meyer

Looking at the industry response to the recent study released by the Center for Studying Health System Change, Physicians Slow to E-mail Routinely with Patients – Issue Brief No. 134, it appears that a piece of the puzzle is missing. Both the study, and the analysis, put the physician at the center of the email debate. In reality, about 30% of a medical practice’s communication is from the …

Read more…

Physician email implementation inertia

Senior leaders need to periodically reflect on their role

John Halamka, MD

Physician

October 25, 2010

Leaders often think about succession plans for their direct reports, but what about themselves?

What if I had a serious health problem or accident that impaired my ability to lead my IT organizations? Here’s my brief analysis.

Beth Israel-Deaconess Medical Center

My role at BIDMC is to document the strategies prioritized by our governance groups, ensure our organizational chart structure is optimized for executing the strategies, …

EMR ROI depends on workflow improvements

Mike Koriwchak, MD

Health Technology

October 23, 2010

Some of the toughest obstacles to EMR are the physician doubters.

These people say, “My charts are going to be on a computer. So what? All I know for sure is that it will take longer for me to finish my charts every day and we will have another component in fixed overhead. Why this is a good idea?”

The concerns are valid. When my practice chose to get EMR 6 years …

Challenges facing patients adopting personal health records

Kristina Fiore

Health Technology

October 14, 2010

by Kristina Fiore

They’re still there. Rows upon rows of number- and color-tagged manila charts, packed in so closely together that Fiore sometimes sticks to Fiori, or hides behind it.

None of my physicians has yet converted to electronic health records. I dream of the day when my PCP can pull up my chart on her iPad, accessing all of the important information (allergies, family history) before …

How open medical charts help Healthy Survivorship

Wendy S. Harpham, MD

Patient

October 8, 2010

[Editor’s note: Please visit part 1 of Dr. Harpham’s take on OpenNotes.]

“Our” Chart

Does the opportunity for patients to read their medical charts help or hurt patients’ ability to become Healthy Survivors?

Open notes can facilitate Healthy Survivorship for some patients.

Unfortunately, other patients may learn something about their condition that makes it more difficult to get good care or live as fully as possible. Or they may experience feelings that threaten the physician-patient bond. …

Health IT and AI in Medicine

Health IT and AI in Medicine

Most Popular

Past Week

Past 6 Months

Recent Posts

Subscribe to KevinMD and never miss a story!

Most Popular

Past Week

Past 6 Months

Recent Posts