"Medicine is a science of uncertainty and an art of probability." - Sir William Osler Two people presented to my clinic on the same day with classic symptoms of head and neck cancer. Each reported several weeks of unilateral throat discomfort, ear pain, and a neck mass. Each was having some trouble swallowing and had changed his diet to accommodate the soreness. When they opened their mouths, each had a mass with a ...

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Earlier this week, as I write this, our office lost a skirmish against technology. It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope (under anesthesia), but most will have back-end work done. We are a small private practice equipped with an outstanding staff. We do our best every day to provide them with the ...

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Following my latest article on health care information technology, and how tragic the situation has become for physicians, I received a lot of correspondence. As always with articles that express physicians’ frustrations with the current batch of IT systems, there’s typically a lot of sympathy and agreement (although I believe that just nodding our heads and saying how bad a situation is, doesn’t really mean that ...

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Computers, more specifically, electronic health records (EHRs), will someday revolutionize the practice of medicine. In fact, successful computerization of medical care is the most critical step necessary to transform the American health care system from its current sorry state to the 21st-century system of our dreams. It is ironic, then, that today EHRs represent one of the worst problems plaguing medical professionals. At this point, many physicians would say that ...

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With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly, the industry is in a state of transition. eCW will be distracted by its 5-year corporate integrity agreement.    AthenaHealth will have to focus on the activist investors at Elliott ...

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I’ve spent a lot of time writing about the suboptimal nature of electronic medical records and what we need to be doing better. At their best, health care information technology systems can make finding patient medical data unbelievably quick and easy. However, at their worst, they take up an unacceptable amount of physicians’ time and also dumb down medicine, reducing our patients’ stories to rows of meaningless tick ...

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It’s more complicated to create an engaging app than many business managers expect. Especially in health care, one of the most complex industries. There are often different, opposing forces at work that make the task more challenging. Your odds of an excellent outcome increase significantly if you keep one word in mind: prioritization. In other words, deeply understanding a user’s priorities based on a changing context makes all the difference. What’s important ...

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Although every technology product released today seems as if it is “powered by artificial intelligence,” the actual AI revolution is ahead of us. When it arrives, it will be on par with the industrial revolution in changing our lives, especially in the world of medicine. John McCarthy, a legendary computer scientist, coined the term “AI” in 1955. He defined it as “the science and engineering of making intelligent machines, especially intelligent ...

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When a new doctor joined our clinic, she spent a week learning our electronic medical record. She had used two other systems before, so she was no stranger to EMRs, but that’s how different they can be. That’s crazy! EMRs should be like cars, which range from the likes of Smart, Mini Cooper, and Skoda to Mercedes Maybach, Rolls Royce, and Porsche. They range from simple to sophisticated, from nimble city cars ...

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At HIMSS, I listened carefully to payers, providers, patients, developers and researchers. Below is a distillation of what I heard from thousands of stakeholders. It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of health care IT implementation and policy making. Knowing where we are now and where we want to be, ...

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