What health care can learn from Katzs Delicatessen Sometime during the last year of the second millennium, I wrote my last letter in response to the last letter I have ever received. It’s been email ever since. I don’t recall making a conscious decision to stop writing letters. It just happened. I cannot pinpoint the exact date when my work memos, agendas, proposals and various notes, disappeared from my desk ...

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Technology finds its way into our lives not so much in big flashy ways as little ones. Oh, I can do this a little bit faster now, isn't that cool? Wow, isn't this convenient? Oh, isn't this a huge risk to my privacy? Oftentimes, when I start talking about Linux or scripting or the command line or any number of tech subjects that seem increasingly esoteric, I get blank stares from ...

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Apps used to monitor blood pressure need better design Here's a design approach that I really, really dislike: the scrolling wheel that is often used for number entry in iOS apps. I find that the scrolling wheel makes it very tiresome to enter numbers, and much prefer apps that offer a number pad, or another way to touch the number you need. (Or at least decrease the number at ...

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The stethoscope has been a symbol of the medical profession for two centuries. Dr. René Laennec probably had no idea how his idea would take off when he first invented the simple wooden tube in Paris back in 1816. After a few modifications over the course of the next several decades, it evolved into what we know today. A central part of the physical examination, the stethoscope currently gives doctors priceless information about the cardiac and ...

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I always pay attention to the reaction I receive from an audience at a talk or individual I encounter when I discuss the difference between a tool and a solution. Marketing a technology as a solution before it has been trialed, integrated into clinical workflow or even an EHR can even be met with legitimized skepticism by an educated purchaser. I offer a few thoughts on the subject which are critical ...

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Over the past few months, Beth Israel Deaconess Medical Center (BIDMC) has been exploring the use of wearable computing. In the emergency department we’ve been evaluating an early unit of Google Glass, a high tech pair of glasses that includes a video camera, video screen, speaker, microphone, touch pad, and motion sensor. We have been able to access our internal web-based ED dashboard on Glass, in a secure manner that ensures all ...

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Do you believe that I have to mention this?  I can’t believe it either but since the advent of the EMR, this seems to be an issue; a really big issue.  Amazingly enough, you are there, as a doctor, to treat the patient and not the computer.  You would think it was the other way around with all the bogus quality indicators, meaningful use baloney and pay-for-performance nonsense being stuffed ...

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Should doctors grab a .health domain?So, you're setting up a website for your practice. You thought you'd just grab a .com, .net, or maybe .info. But now there's .health. Will one of those set you apart from the .com crowd? So what do you need to know about these new domains? 1. Will patients come looking for me on .health? The bottom line is that it's highly unlikely patients ...

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The title itself should make us all cringe!  If there’s one thing I know to be true, it is that putting clinicians at the helm of electronic medical record (EMR) design is doomed to create a product with limited scope and lack of forward-thinking trajectory.  Yet, the concept of integrating and considering the physician point of view and workflow is critical to successful EMR functionality. The question is how can clinician ...

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There’s that line about art, “good artists copy, great artists steal.” There’s some debate about if Picasso said it first, but most of us geeks know it from Steve Jobs. Often, I see things from companies and industries outside of health care  -- processes, products, best practices -- which inspire me. I like these little inspirations because they often aren’t rocket science, but nonetheless fuel some creative thoughts about their applicability ...

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