Technology has been moving at a lightning pace the past two decades. Technological advancements have crept into every facet of life, from HD screens that now blare ads at us at gas station pumps to disruptive start-ups like Netflix, Airbnb, and Uber, which have rocked entire industries, the air of change is inescapable. The medical field, on the other hand, remains in many ways the same as it has been ...

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The current American climate seems to champion those outside the establishment and eschew the experience of career professionals. Medicine, like politics, has not been immune to the rise of populism. There exists a growing distrust of traditional medical institutions and a movement to concede medical expertise to the public, particularly evidenced by the development of platforms that crowdsource diagnosis. While online medical crowdsourcing is trendy and has received nearly universal ...

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A few weeks ago, I found myself in the midst of car trouble. A low tire pressure light illuminated my dashboard, and despite my best effort to replenish the air, I had to concede that my front tire was punctured and that I needed to make an emergency visit to an auto shop. As it always seems to go with any car check-up, the mechanics discovered multiple co-morbidities; a nail ...

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The SOAP note isn’t what it used to be. And what it has become needs to be scrapped, because it has made the office practice of medicine cumbersome and unsafe. In simpler times, when medical records were written by and for doctors, the SOAP note represented a significant leap forward in expanding and organizing office notes and also notes from emergency rooms and walk-in clinics. Before that notes sometimes only documented ...

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As part of trying to figure out where telehealth and video visits fit into the primary care setting, this week I got an amazing tour from the director of our emergency department, during which he showed me the program they've developed over the past year. An incredible system, they take patients from triage who report to the emergency department with nonemergent issues, and move them to a consultation room off to ...

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During residency, one of my patients brought a tape recorder to his appointment.  It was a big bulky old tape recorder, that was antique technology ten years ago.  He was older and wanted to record his appointment so he could remember every detail.  His children often called him and wanted an in-depth report of all of his medical visits.  He decided he would audio-record his appointments and send the tape ...

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A computer algorithm learning how to play StarCraft like a champ may raise some eyebrows, but when algorithms start to give the skills of a trained physician a run, job security becomes a futile construct. An algorithm now diagnoses melanoma as well as a dermatologist: A consolation for the dermatologists, though: Folks across the hallway -- the radiologists and the pathologists -- are feeling the heat as well. ...

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One of the topics I write most about and have also done a considerable amount of consulting work on is improving and optimizing health care information technology. I hate to say it, but after a few years of doing this, I’m starting to despair a little from what I’m seeing. It’s a question I never thought I’d ask: But will health care IT ever really get to where it should ...

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Compare the following two versions of the same medical history: Version 1 CC: chest pain Mr. Smith is a 57-year-old white man who comes into the office today for the first time with a complaint of chest pain. He states he has been in generally good health in the past, though he has smoked about 40 pack-years and admits to not exercising much, other than occasional games of golf. He has trouble keeping ...

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As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with health care IT expertise has been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration. So far, no one has been asked anything by anyone related to health care IT. At this early time in the administration, it’s important to offer ...

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