It happened again.  Yesterday, I was charting on the recently launched streamlined version of our electronic health records and a new note popped up in the right lower corner of the screen: "Welcome to (our new texting system).  Now you can instantly and securely text about patient care with all of your colleagues." A few seconds later, a message popped up.  “You have one unread message.”  As with most other communication systems, ...

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One of the topics that I write most about is the interaction of health care information technology with frontline clinical medicine, which I believe to be among the most critical issues facing the practice of medicine at the moment. With statistics now suggesting that doctors (and nurses) are spending an absolute minimal amount of their day engaging in direct patient care — some research suggesting as little as ...

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One of my favorite things about being an entrepreneur is the people I’m privileged to meet and spend time with.  This week I met a fellow Montana physician, Alistair MacDonald, who has started his own company.  He’s created a product that automatically decreases the volume on music playing in the operating room if a patient's vital signs are tanking.  It seems like an important idea to me.  He made some ...

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Acute kidney injury (AKI) is hard. Things that seem like they should work often don't. Just ask Perry Wilson. And even the most predictable cases of AKI are resistant to intervention. Look at bypass surgery. We know days in advance the time and place the AKI will occur and despite that foreknowledge, like Cassandra, we are powerless to prevent the AKI. Same with contrast administration (or not). Same ...

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Imagine my surprise and delight when I saw my dentist this week for a check-up and found the electronic health record (EHR) to be both informative and patient friendly. As I sat in the dental chair, the large monitor screen was swung over in front of me, and my dentist was at my side going over it. The monitor was not a barrier; it was part of my exam. The ...

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Over the past few months, I’ve been in England, China, Denmark, New Zealand and Canada. Each of them is rethinking their health care IT strategy and is not entirely satisfied with past progress. I’m often asked by senior government officials to help harmonize IT strategy at the country level. That — I can do. I frequently say that health care IT issues are the same all over the world. Here are a few ...

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Many organizations have asked me to comment on the impact of the Trump presidency on health care and health care IT.    I served the Bush administration for four years and the Obama administration for six years.   I know that change in Washington happens incrementally.   There is always an evolution, not a revolution, regardless of speechmaking hyperbole. What am I doing in Massachusetts?   I’m staying the course, continuing ...

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During the Q&A period after a presentation I gave recently on understanding and preventing physician burnout, a physician in the audience voiced her vehement objections to the current electronic health record (EHR) with a simple statement: “We need a revolution.” In a few words, she described her frustrations with the EHR. “It is meaningless -- full of fields that we cut and paste from other fields. There are an ever-growing number ...

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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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