Recently, I was dining with elite radiologists. In that uncomfortable silence between dessert and the check, I said, “radiology must shift the traditional paradigm by creating value streams using disruptive innovation to leverage population health to build strong ecosystems and a robust ectoplasm.” I was experimenting if excreted verbiage hastens the check. Instead, it sparked a vigorous conversation about disruptive innovation, compelling me to drink more cognac. In health care, no two ...

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Dr. Lisa Rosenbaum has an excellent piece in the NEJM entitled "Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine."  In essence a review of Dr. Robert Wachter’s book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, it deals with the ever increasing intrusion of the digital-industrial medical complex on the practice of medicine.  Bottom line: Electronic health records ...

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I have recently discussed imperatives of patient-centric health care, creating patient engagement, and potential value of various digital health technologies. Apart from these considerations are those involving roles of stakeholders and barriers they face in adopting technologies and optimal models of adoption. Not lost in the technical, regulatory, and clinical issues required to be addressed are ...

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I have a love-hate relationship with the electronic health record (EHR). To be precise, it's 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages. I've been in practice long enough to straddle the transition from paper ... to even more paper (thanks EHR, you're the ...

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I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for ...

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I recently read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.”  The article states that, despite massive public funding of electronic health records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who purchase their systems. We are talking about gag clauses that prevent criticism by ...

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shutterstock_188507768 As a family doctor, I have seen a dramatic shift in the range of people I work alongside every day -- all for the better. When I was in training, most family doctors worked only with other family doctors and registered nurses. Today my health care team is rich with a variety of critical skills, including social workers, psychologists, and dieticians. There ...

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emr Modern electronic health records (EHRs) have become the norm in U.S. health care -- nearly 80 percent of office-based physicians use them, up from 40 percent in 2009, according to federal data. But while adoption is up, satisfaction has plummeted. In 2010, about 61 percent of physicians liked their EHRs (were satisfied or very satisfied, according to periodic AMA surveys). This dropped ...

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Dr. Google has been the brunt of numerous jokes and various denigrations from the medical community for some time.  The most recent such offering to come to my attention was from Tanya Feke who seems to want Dr. Google sued for malpractice.  As one who was instrumental in the construction of the Internet, which allowed the creation of Dr. Google, I read these attacks with mixed emotions.  I ...

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unnamed Heath care documentation is done for three reasons:

  1. health care delivery (that’s the obvious one)
  2. regulatory compliance (checking all the boxes our government and payers think are important)
  3. malpractice avoidance (no one wants to get sued)
These three categories actually apply to every task we do in health care, but let’s confine this discussion to documentation. Note in the accompanying figure, our three basic health care work ...

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