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.

Meaningful use letter for the hospital board and senior leaders

John Halamka, MD

Health Technology

August 10, 2010

In January, I wrote a Do it Yourself presentation on meaningful use for folks to use with their Board and Senior leaders.

Now that its August, there is a different kind of Do it Yourself document – a letter to your Board and Senior leaders outlining your plan and timeframe for certification, measurement of meaningful use, and collection of your stimulus funds. We cannot be completely certain about every detail, …

10 EMR don’ts when choosing electronic medical record

Rosemarie Nelson

Health Technology

August 9, 2010

So, you’ve decided to move forward and get an EMR for your practice, but studies and reports of EMR implementation failures are adding to your anxiety levels.

You’ve probably read scores of rules on how to go about the task — some of them in this column. But today I want to share with you some important things you shouldn’t do.

Medical groups of all sizes and specialties across the country make …

Will patients embrace Health 2.0?

Susannah Fox

Health Technology

August 7, 2010

Someone going by the name “Darthmed” recently posted a comment that stopped me in my tracks:

… The remaining 95% of “patients” out there are not motivated to become informed, or invest the time/energy/money in using any of these tools. These are the folks that know that fast food isn’t healthy, but are just too tired to choose differently. Some (emphasis on some) will do a standard Google search when they …

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Will patients embrace Health 2.0?

Android and iPhone pros and cons for healthcare

Kevin

Health Technology

August 4, 2010

by Jeff Brandt

I wrote an article for KevinMD.com several months ago discussing the benefits of Android for the healthcare market. I also compared Android with the iPhone. I listed the iPhone’s technical shortcomings and really angered the “believers of all things Apple”. That was not my intent.

Apple’s latest release of iPhone 4.0 and their new operating system (OS) 4.0 corrects many of …

Doctors hiring scribes because of electronic medical records

Douglas Perednia, MD

Health Technology

August 2, 2010

I was visiting with my physician colleague Debbie the other day, which is always a pleasure. She is, by far, one of the best dermatologists I know. She had purchased an electronic medical record (EMR or EHR) a year or two ago and I asked her how it was going.

“Pretty well,” she said, “but I’ve had to start using a scribe. It’s just too inefficient any other way. I was …

Should we worry about physician privacy in the EHR era?

Margalit Gur-Arie

Health Technology

July 28, 2010

As we move to electronic health records (EHR), the debates over security and privacy are becoming more frequent and more poignant.

We of course have HIPAA laws on the books and Office of the National Coordinator for Health Information Technology (ONC) has a Tiger team assembled to recommend privacy and security policies to Secretary Sebelius.

CIOs and entire IT departments are all focused on protecting the privacy of patients and their Personal …

The art of medicine and whether computers can replace doctors

Eric Van De Graaff, MD

Conditions and Diseases

July 27, 2010

My medical school at the University of Utah developed a clever computer program in the late 80s that was meant to both educate medical students and assist in the treatment of patients.

For several years the tech geeks at the school had collected an immense database of information from all the patient admissions at the hospital—presenting symptoms, exam findings, tests, and final diagnoses. They took all this data and crunched …

The Apple Genius Bar could learn some bedside manner

Rahul K. Parikh, MD

Health Technology

July 26, 2010

My life is wired by Steve Jobs and Apple. When I was a kid, my first computer was an Apple IIc, followed by Macintosh Plus for college. In residency, I used a Newton for a while to take notes on patients. I have a MacBook, an iPod (I’ve actually had 3 and my wife has had 2), an iPhone, iPhone 3gs; an iPhone 4 on order; an iPad, AirPort Express, …

Final meaningful use rules for electronic health records reaction

Kevin

Health Technology

July 14, 2010

by Joyce Frieden

The Department of Health and Human Services has released its final rule on “meaningful use” of electronic health records with the goal of making it easier for physicians to comply.

“We want these objectives to be ambitious but achievable,” David Blumenthal, MD, MPP, the department’s National Coordinator for Health Information Technology, said at a press conference on Tuesday announcing the release of the …

Why technology and the Internet may not be good for patients

Kent Bottles, MD

Potpourri

July 12, 2010

Paro the robot baby harp seal was the final straw.

I had vowed to myself not to think about or write about “the internet makes you smarter, the internet makes you dumber” argument. Even when some of my favorite authors (Steven B. Johnson, Clay Shirky, Nicholas Carr, and Jonah Lehrer) weighed in, I thought it best not to participate.

And then I read about Paro, either “a disturbing turn in our treatment …

iPhone, Android or Blackberry? The right smartphone for doctors

Iltifat Husain, MD

Health Technology

July 11, 2010

Lately, I’ve often been asked the question, “What type of smartphone should I get?” by my medical peers. I’ve been asked this by physicians, residents, medical students, and others. Many of my friends are entering residency and plan on upgrading to a smart phone, while others already entrenched in residency have phone contracts finishing up.

The answer to this question is not easy. Rather, as Facebook nomenclature would demand, “it’s complicated”. …

How to implement CPOE successfully at your hospital

John Halamka, MD

Health Technology

July 9, 2010

One in every 10 patients admitted to six Massachusetts community hospitals suffered serious and avoidable medication mistakes. This has created a new urgency for all hospitals in the state to install computerized physician order entry (CPOE).

At BIDMC, we implemented CPOE in 2001 and have not had a handwritten order in most areas, except for the 2 days of our network outage in 2002. Implementing CPOE is challenging and requires …

Best free Android medical apps

Kevin

Health Technology

July 7, 2010

by Brett Einerson and Iltifat Husain

Health care professionals and students using Android are probably wondering what free Android apps may be helpful in the health care setting.

Android developers continue to add more apps to the Market that relate to health and medical practice. While the field of apps relevant to health care professionals on Android lags far behind the iPhone OS platform, there are several apps worth noting.

Here, we …

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Best free Android medical apps

How to choose an EHR after a demo

Rosemarie Nelson

Health Technology

July 7, 2010

Selecting an EHR is not just about the demo. But those EHR vendors sure do put a lot of focus on that demo! You need to get beyond the smoke and mirrors and consider how to use that focus to evaluate the solution as it meets your needs and requirements.

Before you even schedule any vendor demonstrations, write down your “must haves.” Can you identify your top 10 requirements?

For example, in …

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How to choose an EHR after a demo

How EMR and EHR systems can kill patients

Margalit Gur-Arie

Health Technology

June 29, 2010

Back in the times when EHRs were just EMRs, they had a very simple and humble mission.

The software was supposed to help providers of health care services better manage their business. EMRs were supposed to help physicians adhere to CMS documentation rules, automate patient flow management and get rid of all the mountains of paper floating around a typical medical office or hospital. It was assumed that EMR software will …

7 disruptive changes that will affect medicine

Stephen C. Schimpff, MD

Health Policy

June 24, 2010

Generally we prefer calm seas but often they don’t get us anywhere.

We need disruptions, transformations to make the changes necessary for real progress in medicine. Sometimes it is a new technology; sometimes a cultural change. But then a refinement may occur. The refinement may not seem like a “disruption” but indeed it can be because the refinement may create a demand for change.

Here a few more disruptive changes or refinements …

What if blogs were run like a paper medical record system?

Rob Lamberts, MD

Health Technology

June 20, 2010

I always find it very ironic to see doctors bashing EMR on the Internet. They are bashing a tool designed to gather and organize information, improve communication, and give immediate access to important information, while using a tool that gathers and organizes information, improves communication, and gives immediate access to important information.

It is fine to bash the current state of EMR (I saw one site complain that EMRs have a …

Why the medical chart may not improve patient care

Edwin Leap, MD

Physician

June 15, 2010

Why do we physicians chart the way we do? Hopefully, you do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.

It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually …

iPhone app that empowers patients may be harmful instead

Satish Misra, MD

Health Technology

June 15, 2010

Unless you spent the last two years in a Himalayan monastery, you are certainly aware of the bitter healthcare battle that unfolded in Washington.

Underlying the nonsense about death panels from the right and claims of impending doom from the left lies a far more legitimate conflict about how we view healthcare – as a basic human right or as a market service. Conservatives generally ascribe to the latter, viewing non-emergent …

Health IT and AI in Medicine

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