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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The business value of medication adherence tools is coming into focus.  For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale.  That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products. The poster child for ...

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Dear health care technologist or regulator, The world of health care is changing exponentially. Speaking as one the nation’s over 800,000 physicians, I can confidently say that most of us understand the fact that the current health care system is unsustainable, and can’t carry on as is. There are many potential solutions to explore, and everyone in health care needs to try to come together in an attempt to address these ...

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Some dear friends of mine, at Busy Community Hospital, are having a momentous day.  Today is the "go-live" for their brand new, shiny EMR. For those of you outside the hallowed, creaky halls of medicine, this EMR is one of the most widely used electronic medical records systems in America.  It’s big, it’s expensive, it captures lots of data, integrates ERs, hospitals, clinics, labs and everything else.  (Probably your cat’s shot records too.) The problem ...

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“Then it’s me and my machine For the rest of the morning, For the rest of the afternoon And the rest of my life.” - James Taylor, “Millworker” It’s Friday afternoon, 4:30. I am sitting in front of my computer. My last patient is gone, my prescriptions are done, my messages answered, my office charges submitted and my office notes completed. Now, it’s time to tackle the incoming laboratory results. Opening up the list of completed ...

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The mouse is a piece of technology that we’ve all got very used to working with over the last couple of decades. They actually go back longer than we might expect — the British Royal Navy first used a version of the mouse in the 1940s. With the personal computing revolution of the 1990s, they entered almost every single American household. Go back ten years, and nobody could have imagined ...

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