“I’m here to say ‘Yes, they can,’ which is different from ‘Yes, they always do,’” says James Moore, MD, president-elect of the California Society of Anesthesiologists (CSA). To the contrary, enthusiasm for electronic medical records (EHRs) is part of a “syndrome of inappropriate overconfidence in computing,” argues Christine Doyle, MD, the CSA’s Speaker of the House. The two physician anesthesiologists (and self-identified “computer geeks”) squared off in a point-counterpoint debate in New ...

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One of the major reasons that health care providers resist implementing an electronic medical record (EMR) system is the belief that using it will decrease provider productivity, reducing the number of patients they can see and therefore reducing practice revenue. However, an EMR that is designed around a streamlined workflow can enable providers to work faster and more efficiently. Having an EHR and vendor that can give you ongoing visibility and ...

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Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination. One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and ...

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It has been 5 years since the passage of the HITECH Act portion of the Affordable Care Act. The purpose of HITECH was "to promote the adoption and meaningful use of health information technology." While the result of this legislation has been the significant increase in the adoption of EHRs, most of the potential benefits of digital technology have yet to be demonstrated. there are multiple reasons for this lack of proof. The ...

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The idea of starting over with computerized electronic health record (EHR) systems and doing them right as mentioned in a previous post has struck a resonant chord. Unfortunately designing an EHR that works may be a fantasy, due to one huge hurdle that would have to be overcome first. But it is fun to imagine an alternative universe where EHR systems were patient-centric instead of being ...

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Over the past 5 to 10 years, hospitals and physician offices have been in a mad dash to implement electronic health records (EHRs) in order to meet governmental regulatory requirements.  Now that most projects are either complete or well on their way, what are we doing with all of the data that EHRs promised to generate? From my experience as a physician at a large academic medical center with one of ...

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After listening to a lecture, third-year students at the Harvard School of Dental Medicine were surveyed about distractions by electronic devices and given a 12-question quiz. Although 65% of the students admitted to having been distracted by emails, Facebook, and/or texting during the lecture, distracted students had an average score of 9.85 correct compared to 10.444 students who said they weren't distracted. The difference was not significant, p = 0.652. In ...

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Few will argue that the overall health of Americans has deteriorated in the past quarter century.  Diabetes or prediabetes afflicts nearly 120 million people. Roughly two of three Americans are either overweight or obese. Pharmaceutical companies focus on drug discovery as a solution.  Thousands of apps for smart phones are being developed to change our destructive behavior.  But, lacking in both of these is a true solution, one that draws ...

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The EHR report card 2014: Has it gotten better?A guest column by the American College of Physicians, exclusive to KevinMD.com. A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed.  As in 2012, I will not identify my ...

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I had little doubt the long-rumored Apple Watch would be cool. U2′s live concert and surprise album announcement at Apple’s unveiling a few weeks ago only reaffirmed the company’s ability to launch a product unlike anyone else. Cool or not isn’t the question. Usefulness is. The iPhone and iPad radically changed how people lived their lives. The first generation of the Apple Watch won’t. The health application One way Apple hopes to increase ...

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