Please choose one: The three words blink in front of me on the computer screen. Please choose one: Patient is-Male     Female  I click FEMALE. I watch as the auto-template feature fills in the paragraph for me based on my choices. Patient #879302045 Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history. I click YES. Have you counseled her about smoking cessation? I click NO. A little, animated icon of a doctor pops up on the screen. His mouth begins ...

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Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records. Chief among these are the ability to access the chart from anywhere, rapidly search for information needed, and reducing the centuries-old problem of illegible doctors’ handwriting.  But with the good comes the bad, and in these still relatively early stages of health care information technology adoption -- ...

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The other day I ordered a CT scan with contrast on a patient with an apparent mass on his neck. I explained about the need to get a blood test to make sure his kidneys could handle the iodine contrast. Because our lab was closed, I had to print a requisition for him to bring to the hospital lab. Printing a requisition from our EMR is a multi-step process that involves ...

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As our medical system attempts to evolve to better deal with the modern epidemics of lifestyle-driven chronic disease, much time and attention is being placed on the clinical models for prevention. Rightly so, and various viable models are popping up with names like lifestyle medicine, preventative medicine, and functional medicine. But one area that is hardly addressed is the payment structure and business model of the practices. Are there structures that ...

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First off, this is the first time I have typed an official response to a blog post: "Dear health IT: Please understand our frustrations."  You might think, hey aren’t you a millennial, shouldn’t you be blogging non-stop?  Like doing everything from my taxes to baking with my smartphone?  No, not really; besides residency doesn’t make it very feasible either. Yet, the need to respond to Dr. Leap’s blog post was ...

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Remember the Latin phrase “Primum non nocere”? It means “First, do no harm.” Most of us physicians committed to it when reciting the Hippocratic Oath, back when we were first embarking on our careers in medicine. Sadly, today’s technology threatens this sacred physician-patient relationship. Electronic health records (EHRs), although much-needed, have created perverse, unintended consequences for the patient experience. To be clear, EHRs are inherently good.  They’re the backbone of better-coordinated care, ...

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It has been quite a year.  Between 3 main hospitals, 2 major medical institutions and 3 major healthcare networks, our practice has been on 3 different echocardiographic reading platforms, 3 ECG reading platforms, and 8 different electronic health record systems including 4 instances of Epic alone. I am typically enthusiastic to a fault about new technologies and, time after time, have rushed in, often where angels feared to tread.  I ...

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shutterstock_116767843 Meaningful. Having a serious, important, or useful quality. You know this word because you want it to define your life. Nearly all of us, at some point, will seek a more meaningful existence. Most wish our jobs were that way too. Meaningless. Having no purpose or reason. Ouch. We don’t want anything to do with that. Meaningless makes us question what in the ...

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I just deposited a check into my bank account by photographing the check with my iPhone and zapping it through cyberspace.  I realize this is ho hum to the under 35 crowd.  Soon, there won’t be any paper checks as the entire transaction will occur electronically.  As a member of the over 35 crowd (plus 20 years), I am wowed by this process.  I remember being astonished when my kids ...

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shutterstock_140188489 Dear health IT staff, I know that, on many levels, physicians must be the absolute banes of your existence.  We are grumpy and resistant to change. And some of us are still confused by graphing calculators, much less complex modern computer systems.  We call you because we forgot our passwords, then because we forgot the new passwords.  We call because the system ...

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