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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In their current form, most (if not all) EHRs kind of stink. I don’t speak from direct experience, as I’ve held off buying and implementing a system to date. But I’ve never heard any of my colleagues say they love -- or even really like -- their EHRs, and I’ve asked many. The most ardent supporters state that they've gotten used to their systems (usually after years of tribulations) and ...

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With the recent discovery of the ShellShock vulnerability affecting a large number of computers, the question comes up again: How secure is medical data? Thanks to the federally mandated push to transfer medical data from paper charts to computer databases, most if not all of this data is now fertile ground for hackers. As pointed out in this article medical data is more valuable to hackers than stolen credit cards. ...

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I saw another exciting news story on a mobile health intervention the other day.  I honestly don’t remember the company or product, but what stuck with me was the declaration of success based on 10 patients using the product for three months.  Success was touted in terms of cost reduction and resource utilization reduction in a before/after analysis.  This inspired me to collect some thoughts on some of the challenges ...

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Who is blocking EMR interoperability? You are. The Senate Appropriations Committee has defined a new transgression perpetrated in the committee’s expert opinion by vendors of certified EHRs, as well as “eligible hospitals or providers.” Since the committee has no data or evidence of any kind that this transgression is actually occurring, it requires the Office of the National Coordinator for Health Information Technology (ONC) to embark on a ...

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