I recently discussed both the merits and needs for the use of mobile technologies in clinical trials. Recruiting patients via social media is now a reality and has been a topic of discussion in many forums, including mainstream medical journals.  There is no question that online patient support groups serve unique purposes. There are regulatory issues involved in this arena. However, new regulatory frameworks need to be developed in the age ...

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On Monday March 30, 2015 our Greenway PrimeSuite electronic health record had a system-wide failure at the level of the Edgemed Computer service center in New York State. It meant that I was back to using pencil and paper to interview patients and record the answers and physical findings. With much trepidation, I began seeing patients with two sheets of white blank paper on a clipboard and my trusty pen. To ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. So far, 2015 has been a busy year for reflecting on the use of electronic health records (EHRs). CMS just released its proposed rules for meaningful use stage 3. One might say that “MU 3” supports the belief that the sequel is never as good ...

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A recent piece in the New York Times profiled a young man with a remarkable medical history, and an equally remarkable approach to sharing it. I think it raises some profound issues regarding the self-monitoring movement and the “ownership” of patients’ health information, both of which have the potential to change our traditional practices in a big way. The guy -- Steven Keating -- is not your average Joe. He is a ...

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I drank the Kool-Aid early.  We installed our first EHR in 1996 with me doing the lion’s share of pushing and pulling.  While I’d ultimately turn my back on this passion, I had a number of notable accomplishments before walking down my road to Damascus.

  • Within a year of implementation, our practice became one of the top installations for our vendor.
  • Within two years, I was elected to the board of our user ...

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The nightmare sickens me. A small child trusts a man to protect her, take care of her, and shield her from harm. The man, for incomprehensible and useless reasons, neglects her unto death. For me, when I think of Germanwings flight 9525, I am haunted by the photo of a single tiny girl, taken in the last days of life; the obliteration of that perfect life’s potential. Waste, tragedy, evil. In the ...

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On March 20, 2015 the stars aligned to produce four simultaneous events that will never again coincide during the life of human civilization. The first three, the vernal equinox, a total solar eclipse and a new supermoon, were brought to us by the stars themselves, and the fourth one was thrown out there by the government. The regulations for meaningful use stage 3 were finally published. Meaningful use of electronic health ...

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As the rugged beauty of the Pacific Coast unfolded in all of its splendor, I was in awe of the entirely different experience: the one created by our Uber driver, Calvin (name changed to protect anonymity). My friend and I, attending our annual cardiology meeting in sunny San Diego, carved out a few hours of rest and relaxation. We were heading to La Jolla, a scenic seaside community about 20 minutes ...

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Sometimes, after crafting an important or complex plan of care with a patient, I say: “Let me type all this into the computer so that, in case I run into that big bull moose up on Vaillancourt Hill on my way home tonight, the next doctor who sees you will know what we were thinking today.” Patients sometimes squirm or laugh nervously at that, but then they usually indicate understanding and ...

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As medical providers, we recognize the value and importance of emergency medical identification (EMI), especially for our patients who live with chronic medical conditions, such as diabetes, epilepsy, and severe allergies. Of particular concern are those who may require emergency care during a time when they are unable to communicate, but how often do we address this topic with our patients, and do they really listen? Health care professionals have long recommended that such patients obtain emergency medical identification, such as MedicAlert jewelry (bracelet, ...

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