The patient looked angry and I felt his frustration. His voice was rising, “Why is the chart 54 pages long? My son has only been here five times!” In the olden, pre-electronic health record days, chances are the chart would most likely have been less than 10 pages. However, since the government takeover of medical records, this is no longer the case. When the government rolled out its meaningful use ...

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I recently had the opportunity to join Boston news media veteran, Dan Rea, on his AM radio program, Nightside with Dan Rea. It was a one-hour call-in program and an eye-opening experience for me. Dan and I chatted about connected health and how it can truly disrupt care delivery and put the individual at the center of their own health. Then Dan opened the lines to the ...

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The business value of medication adherence tools is coming into focus.  For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale.  That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products. The poster child for ...

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Dear health care technologist or regulator, The world of health care is changing exponentially. Speaking as one the nation’s over 800,000 physicians, I can confidently say that most of us understand the fact that the current health care system is unsustainable, and can’t carry on as is. There are many potential solutions to explore, and everyone in health care needs to try to come together in an attempt to address these ...

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Some dear friends of mine, at Busy Community Hospital, are having a momentous day.  Today is the "go-live" for their brand new, shiny EMR. For those of you outside the hallowed, creaky halls of medicine, this EMR is one of the most widely used electronic medical records systems in America.  It’s big, it’s expensive, it captures lots of data, integrates ERs, hospitals, clinics, labs and everything else.  (Probably your cat’s shot records too.) The problem ...

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“Then it’s me and my machine For the rest of the morning, For the rest of the afternoon And the rest of my life.” - James Taylor, “Millworker” It’s Friday afternoon, 4:30. I am sitting in front of my computer. My last patient is gone, my prescriptions are done, my messages answered, my office charges submitted and my office notes completed. Now, it’s time to tackle the incoming laboratory results. Opening up the list of completed ...

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The mouse is a piece of technology that we’ve all got very used to working with over the last couple of decades. They actually go back longer than we might expect — the British Royal Navy first used a version of the mouse in the 1940s. With the personal computing revolution of the 1990s, they entered almost every single American household. Go back ten years, and nobody could have imagined ...

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Speech recognition errors occurred in 71 percent of emergency department notes, and 21.1 percent of notes with errors were judged as critical with potential implications for patient care says a recent study in the International Journal of Medical Informatics. Investigators looked at a random sample of 100 dictated notes and found 128 errors or 1.3 errors per note. More than half of the errors were ascribed to speaker mispronunciation. Although ...

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I enjoy being a physician. I really enjoy being a physician. Although much of my blog is focused on areas where we need to improve health care, with a particular recent focus on the burdens of information technology, that does not take away from the fact that I do really love my job as a doctor. I’ve received a lot of supportive correspondence regarding my views on how electronic medical records ...

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Patients seem to be increasingly comfortable managing their health care through digital media. Last summer, our private practice of eight retinal specialists decided to find out exactly how comfortable. From July to August, 2015, we conducted a survey of 200 of our patients during their office visit and asked them what health-care related tasks they were already doing online. Using this data, we’re starting to look at how our medical practice might ...

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