Adding “electronic” means sortable, searchable, bigger attic, more junk. Unfortunately, no one has the guts to actually clean it. Are urinalyses from the 90s still important, or are we just being sentimental? For everything we do in medicine, there are intended effects and side effects. During my emergency medicine residency there was a mandate that attending physicians had to see each patient cared for by their residents. While a hard transition, ...

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A decade ago, electronic health records were aggressively promoted for a number of reasons.  Proponents claimed that they would facilitate the sharing of health information, reduce error rates in health care, increase health care efficiency, and lower costs. Enthusiasts included the technology companies, consultants, and IT specialists who stood to reap substantial financial rewards from a system-wide switch to electronic records. Even some health professionals shared in the enthusiasm.  Compared to the ...

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Evolution is part of life, something we accept as a fact and evidenced by the changes we see and know compared to hundreds of years ago. No one can dispute the great technological advances that have been made; transport has been revolutionized from the animal power of horse and cart to the mechanized systems of train, plane and automobile we have today. Communication systems once reliant upon the written word and ...

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We live in a headline/hyperlinked world.  A couple of years back, I learned through happenstance that my most popular blog posts all had catchy titles.  I’m pretty confident that people who read my blog do more than scan the titles, but there is so much information coming at us these days, it’s often difficult to get much beyond the headline.  Another phenomenon of information overload is that we naturally apply heuristics or ...

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For years, many physicians have complained about the onerous nature of government-certified electronic medical records. However, thanks to the HITECH Act, the rush to digitize medical records has continued. Due to the impetus provided by the ACA and subsequently by MACRA, the mad rush has progressed into a frenzy of data-collecting and reporting activity, all in the name of value over volume. Recently, two objective reports have surfaced demonstrating the futility of ...

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I was at a locums assignment yesterday using FEEMRS. (You know, "Fancy Expensive Electronic Medical Records System.") It was all kinds of busy, with wait times of many hours. And as I slogged along, relearning FEEMRS after a few weeks away, I realized that it takes about one hour of looking at that screen for me to become exhausted. It’s just too busy. Every bit of the screen seems filled with ...

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I order pregnancy tests on men. In fact, I do it pretty frequently. Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since. Despite this, I still order pregnancy tests on men. Perhaps ...

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One of the biggest topics today in the health care field is that of meaningful use.  Meaningful use is defined as using certified electronic health record (EHR) technology to improve quality, safety, efficiency, and reduce health disparities.  The promise is that meaningful use will help improve patient and provider communication and increase care coordination while maintaining the privacy and confidentiality of patients. However, serious questions are emerging about whether this is ...

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I know a wise old forester. Ask him any question and he'll answer, “Well, now, it depends on what you want.” “Should we clear this underbrush or just leave it?” It depends on what you want. I realize this can explain any choice we've made: that is, we have what we have because, at some level, that's what we want. In that light, let me discuss electronic medical records. EMRs can be wonderfully ...

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We’ve got a long way to go before information technology solutions at the frontlines of health care fulfill their enormous potential. The suboptimal, clunky and cumbersome design of most IT systems is responsible for much misery among physicians and nurses on a daily basis. Part of the problem is that hospitals and clinics have rolled out these solutions rapidly and somewhat haphazardly to fulfill meaningful use requirements and gain much-needed ...

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