It’s hard to teach an old dog new tricks, but we can try.
To write or to type, that is the question. To boldly go (according to the latest statistics) where only a small few are going; that is the challenge. Actually, for everyone in the medical profession, the reality of the paper chart is slowly coming to a close.
The digital age is moving forward at lightning speed.
But can you teach …
Benefits of EMR outweigh the cost and learning curve
The regulators have completed their work. CMS has defined how you should use technology in your practice or hospital (Meaningful Use) and technical requirements for EHRs have been finalized.
Centers for Medicare & Medicaid Services (CMS) and Office of the National Coordinator for Health IT (ONC) have removed all ambiguity regarding Government financial assistance to those purchasing EHRs, and ONC certified EHRs will start appearing shortly.
A national network of federally funded …
Why doctors need an EHR, and why they should buy it now
by John Rossheim
IT professionals are great at coming up with nifty tools for bringing clinical data to clinicians – as long as nurses are willing to memorize lots of byzantine paths to that information.
Nurses are dedicated to providing direct care for their patients and advocating for them in every way – as long as it doesn’t mean having to adapt to ever-changing computer systems.
These two stereotypes …
Coping with the culture clash between nurses and IT
It’s widely rumored that a health IT industry executive was unhappy about suggestions that systems have to be usable in the eyes of employees who use them while caring for us. (Us. The patients. Your mother.)
According to the rumor, the exec said, “Over my dead body.” As if he ran the agency.
Whether or not the rumor’s true it’s not funny. So when I was asked to represent the patient perspective …
Why health IT usability matters to patients
We are a little over two years into our electronic medical records implementation at the time of this writing. Since we have been performing a gradual rollout, the entire process has been relatively uneventful. Most of the credit for this goes to our chief information officer (technospeak for the head of our IT department) and our practice administrator.
One of the biggest challenges we have been facing is how to convert …
Converting paper charts to electronic medical records tips
Dr. Wes, a blogging cardiologist, posted a follow-up to his recent post on e-mail correspondence between physicians and patients.
The majority of emails he receives tend to be for very simple things like checking a lab result.
Current EMRs don’t make reviewing and sharing lab values efficient. Dr. Wes writes:
[O]ur current model of the electronic medical record sending every single result to our inbasket, even though it contains …
Physicians deserve to be compensated for time spent on email
I recently completed a two week tour of duty on the wards in July with new residents, interns, and students.
Attending (serving as the supervising doctor for the team of residents, interns and students) in July can be challenging, but also one of the most rewarding clinical experiences as a faculty member. The interns and residents are eager to learn and your teaching may have a more lasting impact as the residents …
Powerful examples of using the iPad on the wards
by MedInformaticsMD
As a result of my mother’s health IT-related cerebral hemorrhage and resultant multi-month hospitalization, with transfers to nursing homes then back to acute care due to setbacks, I recently had the chance to observe her care in a small community hospital.
This was a hospital that, in her last several days there before going back to a nursing home …
How CPOE violated medical ethics
I recently joined my team while troubleshooting a complex infrastructure problem affecting our community EHR hosting private cloud.
From years of experience doing this, here are my lessons learned.
1. Once the problem is identified, the first step is to ascertain the scope. Call the users to determine what they are experiencing. Test the application or infrastructure yourself. Do not trust the monitoring tools if they indicate all is well but the …
10 tips for troubleshooting complex EHR infrastructure problems
by David C. Kibbe, MD, MBA and Brian Klepper, PhD
Finally, we have a Final Rule on the Medicare and Medicaid EHR incentive programs.
The rules and criteria are simpler and more flexible, and the measures easier to compute. But they are still an “all or nothing” proposition for physicians, who will have to meet all of the objectives and measures to receive any incentive payment. Doctors …
Beyond the final Medicare and Medicaid EHR incentive rules
After 5 successful years with electronic medical records (EMR), I am convinced that the promise of EMR to improve physician practices and to improve the health care system is real.
If that is true, why is adoption of EMR currently limited to only 5-10% of medical practices? Why is there so much resistance? As folks who work in heath care IT so often ask, why don’t doctors “get it?” I don’t …
Physician resistance to EMR and why CPT should be replaced
This evening I went to a meeting of many of the independent physicians in our community who came together to discuss ways we can help each other to remain viable as relatively small independent practices of medicine. Two things about the meeting really hit home for me.
First is how seldom I get to meet socially with my fellow physicians in the community. Now that many of us use hospitalists to take care …
We need a better way to share information to care for patients
Recently, yet another alarming Computerized Physician Order Entry (CPOE) study made headlines.
According to Healthcare IT News, The Leapfrog Group, a staunch advocate of CPOE, is now sounding the alarm on untested CPOE as their new study “points to jeopardy to patients when using health IT.” Up until now we had inconclusive studies pointing to increased and also decreased mortality in one hospital or another following CPOE implementation, but …
Computerized Physician Order Entry (CPOE) affects patient safety
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Maybe you’ve been assuming that when it comes time to go live on your EMR, you’ll simply scan each patient’s old paper chart into the electronic system.
Maybe you haven’t given it much thought because you’re focusing on the change in your work flow when you start to use the EMR to document patient encounters.
Well, it’s time to pay attention to the transfer, because the conversion of the paper chart can …
Converting from paper chart to an EMR: Keep daily use in mind
Have you ever read what your physicians and nurses have written in your medical chart? If not, would you want to?
The OpenNotes project is a recently launched observational research study that involves 100 primary care doctors and about 25,000 patients. Lead author Dr. Tom Delbacoa, a primary care physician at the Beth Israel Deaconess Medical Center, poses the research question succinctly: “After a year, will the patients and doctors still want to continue sharing notes?”
In the study, …
Why OpenNotes and access to the medical chart is important
Stories can enhance health websites because they resonate with health information seekers, who find support and encouragement from the experiences of others like them. Two excellent examples are Weight Watchers’ Success Stories and Livestrong.org’s Survivorship Stories. Both sites include extensive libraries of well-written stories about people’s experiences losing weight and surviving cancer, respectively.
Because of the effectiveness of stories in health websites like these, I challenge my Online Consumer Health students …
How patient stories can enhance health websites
The opening anecdote of the e-patient white paper tells of a patient who impersonated a doctor in 1994, to get his hands on an article about an operation he was about to have. He got busted. Two years later episode 139 of Seinfeld had something similar – Kramer impersonates a doctor to try to get Elaine’s medical record.
It aired October 17, 1996. It was a turning point in American healthcare: …
OpenNotes and whether patients should see their medical notes
There’s always a lot of stink from physicians over usability problems with EHRs: too many clicks, too many contextual menus, etc. The gist of these complaints is, “Physicians aren’t data entry clerks!” The computer is getting in the way of their interactions with their patients.
Everybody has a finite amount of mental space available at any given moment. Imagine having to transcribe a conversation in real-time. If half of your mental …
Why nurses need better EMR design to care for patients
by Felasfa Wodajo, MD
Recently, we had the chance to check in with Dr. Henry Feldman. He had posted a detailed summary of his experiences using the iPad as his main interface while rotating on service for a week as a hospitalist at Beth Israel Deaconess hospital (BIDMC) in Boston. Dr. Feldman is also Chief Information Architect for the Harvard Medical Faculty Physicians.
The summary of the …
Apple’s iPad on medical rounds, a hands on physician review
A guest column by the American Medical Association, exclusive to KevinMD.com.
by Steven J. Stack, MD
The high cost of an electronic health record (EHR) system, the often challenging process of implementing new technology into a physician practice, and the difficulty in deciding which system best meets a practice’s needs have deterred many physicians from …
AMA: A roadmap to qualifying for EHR incentives
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