The insurance companies have discovered a new way to give me a headache. About a month ago, a number of providers in our practice received an email with instructions about a new task to which we had been assigned. Apparently, we were supposed to log on to some website, create an account, and fill out a SOAP note on about a dozen of our patients. Wait, a SOAP note? Didn't I write one ...

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I recently spent time at the New York eHealth Collaborative's Digital Health conference. The meeting was full of interesting seminars, informational sessions, presentations on innovative technology looming on the horizon, and talk about the future digital face of health care. The hallways outside the conference rooms were full of administrators, legislators, consultants, and representatives of companies building and designing new resources to help transform the health care system as they see it. Over and ...

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Information is everything, communication is the key. Recently, we were contacted by the medical director of a subspecialist fellow's practice at one of our affiliated hospitals. She wanted to discuss ways to improve communication between our practices, and expressed considerable frustration about the information received in consultation requests from the providers in our practice sending patients their way. She noted that they had "read-only" access to our electronic health record (through an information-sharing ...

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Today was (almost) the last straw. If you've read this column before, you've listened to my diatribes about the insanity of the forms we are required to fill out, the wasted efforts, the missed opportunities, the duplicative care. This one today takes the cake. Going through my mail this morning, trying to clean up the work on my desk before I head off for a (hopefully) few days of jury duty, ...

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A sleeping dragon awakes. At our weekly health policy colloquium recently, the presenter described plans for our organization to form its own accountable care organization, or ACO. The idea behind an ACO is to find patients who get the majority of their primary care within our system, and then "attribute" their health care and all of its attendant costs to that system, making the providers ultimately responsible for providing both high-quality and ...

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It seems like every few days we get a message in the in-basket of our electronic health record (EHR) about a new type of message that we will be receiving in our in-basket. They call these messages "system notices." OK, maybe that's an exaggeration, maybe not every few days, but the different types of in-baskets and all the information we are bombarded with is getting out of control. As users of electronic ...

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shutterstock_155857724 I just got a taste of improved access, and I gotta tell you, it sapped my energy. It reminds me of the old standup comic one-liner, "I just flew in from Vegas, and boy, are my arms tired." Today was the department of medicine housestaff picnic (pretty much a guarantee to cause the weather to change from clear skies to rain), and so ...

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shutterstock_81515077 I was on call last night. Don't get me wrong, this is not as bad as it sounds. With over 20 partners sharing evening call, and residents getting the calls first, we do not have it bad at all. And certainly nothing like my obstetrician friends, who seem to go in every time they are on call for labor and delivery and then ...

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One hundred forty-nine messages. This is what I return to on my first day back from vacation. Many of them were marked with a little red arrow, indicating a high-priority phone message. Recharging with a little time off is a darn good thing, something we all need, and something which has been shown to help all of us be better at what we do. All of us, no matter what our jobs are. ...

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Just the other day I received a somewhat anxious-sounding phone message from a patient of mine, approximately 72 hours after her office visit with me, and about 24 hours after I had already gone over all of her lab results from the visit with her. She sounded quite distressed, and said she'd received a message from someone, but could not really understand what they were saying. She said she was finally ...

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