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.

Electronic medical records and detail obsessed doctors

Paul Sax, MD

Health Technology

June 10, 2010

When it comes to writing consult notes, it often seems as if we ID specialists have a blatant form of obsessive-compulsive disorder. Every detail is fair game — travel history, dietary habits, all sorts of seemingly trivial exposures, and of course microbiologic data stretching back to the Cretaceous period.

I’ll never forget receiving sign-out from the graduating first-year ID fellow when I started my fellowship. It included a photocopy of a …

How to talk to patients with an EMR in the room

Edward Pullen, MD

Patient

June 9, 2010

I see a lot of articles by physicians complaining about how the use of a computerized medical record (EMR) in the exam room with patients detracts from the physician-patient experience.

The complaint usually follows the theme that the physician and patient are not able to have eye contact, and both the physician and the patient feel less intimate and connected during the visit because the physician’s need to use the keyboard, …

EMRs are ugly, and what the next generation of doctors can do

Josh Herigon, MPH

Health Technology

June 8, 2010

I was in our family practice clinic today and couldn’t help but noticing once again that the electronic medical record (EMR) system they use looks like it was designed in the 1980s.

Gray boxes with tiny free text fields and little check boxes. Unfortunately, the aesthetics are the least infuriating design element.

Why is nothing connected in current EMRs? The single most important thing that has led to the proliferation and usability …

Smartphones will be the hub of digital medical care

Jaan Sidorov, MD

Health Technology

June 5, 2010

As a former New Yorker, the Disease Management Care Blog has always had an abiding respect for the Big Apple’s taxi drivers.

That increased considerably after it left its wallet in a Manhattan cab and it turned up in Virginia a year later — in the possession of an individual allegedly involved in organized crime. This and other evidence of the cabbies’ shrewd business acumen makes the DMCB wonder why Hizzoner …

EMR use may not save money but can save lives

MedPage Today

Health Technology

May 27, 2010

by Joyce Frieden

Two new studies of electronic medical records (EMRs) have come to different conclusions: one found that they don’t save money or staffing time, but the other suggested that at least one part of EMR — electronic prescribing — does save lives.

In the electronic prescribing study, at a single California hospital, the mean monthly adjusted mortality rate decreased by 20% …

EHR notes and the cut and paste documentation problem

Jaan Sidorov, MD

Health Technology

May 15, 2010

“Detritus.”

Not only was that a chance for the Disease Management Care Blog to refamiliarize itself with an underused noun (and, er, its spelling), that was the telling term used today by a DMCB colleague to describe the output from a local health system’s electronic health record (EHR).

He had received a copy of a lengthy consultant-physician’s documentation involving one of his patients and was astonished by the blob of past …

How Massachusetts can lead health IT modernization

John Halamka, MD

Health Technology

May 6, 2010

Although healthcare reform has its supporters and detractors, healthcare IT reform – the use of technology to improve the quality, safety and efficiency of healthcare throughout the country – has broad support from all stakeholders.

The passage of last year’s $787 billion economic stimulus bill brought with it a healthcare IT modernization program that could inject about $30 billion into the economy. Since Massachusetts is a leader both in the use …

Problem list problems with electronic medical records

Hans Duvefelt, MD

Health Technology

May 4, 2010

In family medicine it has been common to keep a “Problem List” in patients’ paper charts. Usually placed on the left hand side, on top of the Medication List, it has given doctors like me an instant thumbnail sketch before considering the specifics of each patient’s visit for that day.

A typical Problem List would include diagnoses like diabetes, hypertension, high cholesterol or rheumatoid arthritis. It would list prior surgeries, like …

Doctors need more eye contact with patients, not computers

Lisa Gualtieri, PhD

Physician

April 30, 2010

I had an interesting juxtaposition of events. While waiting in Peets, a coffee shop in Lexington Center, I watched the friendly discussions between the baristas and customers.

I then went to a doctor’s appointment, where a nurse stood typing at a laptop asking me a series of questions, including “Are you in pain?” and “Do you feel safe at home?” She didn’t look at me once as she read and typed.

Eye Contact …

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Doctors need more eye contact with patients, not computers

VA information technology saves billions of dollars

MedPage Today

Health Technology

April 28, 2010

by John Gever

The Department of Veterans Affairs’ long-term investment in healthcare information technology paid off at a rate of more than $500 million in net annual benefits from 2001 to 2007, researchers said.

That added up to more than $3 billion in benefits for the Department of Veterans Affairs (VA) during the study period, after an initial billion-dollar loss.

In particular, the department’s computerized patient record system “was the dominant contributor to …

Real world meaningful use of health IT for physicians

Kevin

Health Technology

April 13, 2010

by David C. Kibbe, MD, MBA

An article in the April 10, 2010 New York Times entitled “Doctors and Patients, Lost in Paperwork,” brought attention to what may be, in the near term, the Achilles heel of the plan to incentivize doctors for the “meaningful use of EHR technology.”

The article cited a study published in the Archives of Internal Medicine this past February, which asked a large cohort of physicians in …

iPad review for doctors: A hands on guide for medicine

Iltifat Husain, MD

Health Technology

April 12, 2010

The iPad has finally been released and we’ve got our hands on one so we can provide the medical community a healthcare perspective of the device. Here are my initial impressions.

Fits in your white coat

The iPad should fit comfortably your white coat. If you continue on to the rest of the review you’ll see pictures of the device easily settling into …

iPhone medical apps may be medical malpractice targets

Satish Misra, MD

Health Technology

April 11, 2010

Medical practice is a big business. Conservative estimates put the total cost of medical malpractice at nearly $35 billion annually and, according to a Kaiser Family Foundation report, nearly $5 billion is paid in claims each year. With an average claims payment of about $300,000 and up to 50% of that going to the lawyers representing the patient, its not surprising that practically every show on cable television has at …

iPad in the ER, a hands on physician review

Larry Nathanson, MD

Health Technology

April 6, 2010

I had been anxiously awaiting the arrival of my iPad. This is the form factor I have been asking (begging) of all the vendors for years. I’m very happy to say that it appears to be living up to my high expectations.

The screen is gorgeous. It’s very clear and bright, I had no trouble seeing the screen in bright outdoor light. The machine seems extremely responsive — it …

Why healthcare may not embrace the iPad

Kevin

Health Technology

March 29, 2010

The excitement and hype surrounding the announcement of Apple’s iPad have subsided for the time being, perhaps just a lull prior to the actual release in a few months. It’s expected that the iPad could make significant contributions to healthcare, such as potentially replacing the physician’s clipboard or medical textbooks.

However, we did disagree at times on the extent to which the iPad could penetrate the healthcare market, for a variety …

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Why healthcare may not embrace the iPad

EMR conversion doesn’t always help physician communication

Kevin

Health Technology

March 16, 2010

by Stuart Sutton, MD

Our very large and very integrated health care system is plowing ahead with EMR implementation. All the offices are gradually converting from paper charts and all the hospitals have completed the process.

As a member of one of the last offices to be converted to the EMR, I’ve had the pleasure of patients being assured that the notes were sent to me (albeit via the EMR we are …

Free iPhone medical apps that every doctor can use

Satish Misra, MD and Iltifat Husain, MD

Health Technology

March 3, 2010

by Iltifat Husain, Yousif Alkadhi, MD, and Satish Misra

If you’re a physician, medical student, or in any other health care related field, trying to find the best free medical apps for the iPhone is a hassle.

Apps such as “Dream Meanings”, “Relax Ocean waves”, and “Stool Scanner Lite” dominate the Top Free Medical Apps list in the App Store. Our top 10 iPhone medical apps list contains no such app, …

Is Google Android or the iPhone the future of mobile smartphones?

Kevin

Health Technology

February 23, 2010

by Felasfa Wodajo, MD

Over the last few months, a great deal of time has been expended on the “hot competition” between Apple and Google in relation to smart phones.

Much of this interest probably had to do with a partially imagined story of a once close friendship between Apple and Google, founded on their mutual enmity of Microsoft, now fractured on the rocks of competition and greed. While the truth probably …

HIMSS 2010 Better Health social media coverage

Kevin

Potpourri

February 18, 2010

This year, the Better Health team will be offering live coverage of healthcare’s largest tech conference: HIMSS in Atlanta, March 1-4.

Three medical bloggers, Dr. Val Jones, Dr. Mike Sevilla, and Dr. Nick Genes will interview over 40 different exhibitors and stream their interviews live via UStream.

You can ask questions of the interviewees by submitting questions to @drval during …

10 ways an Apple iPad can help doctors improve patient care

Joseph Kim, MD, MPH

Health Technology

February 2, 2010

The current (first generation) Apple iPad probably won’t run a robust electronic health record (EHR).

However, it may run some iPhone/iPod touch EHR/EMR apps. I think most physicians will prefer to use a standard tablet PC instead of the iPad. However, given that a large percentage of physicians are not using the tablet in the outpatient office setting, perhaps …