We believe in data. We are scientists after all. And yet in this new era of big data is it possible we are measuring the wrong things? Most measures of physician performance are process or intermediate outcome measures aimed at a production line model of care. Was an A1c done, did the physician use a computer to send an order to the laboratory, were antibiotics given within two hours of presentation. Yet ...

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A wish list for Apples HealthKit Apple has been making headlines again, which is not unusual for a company that sets trends and moves markets. Recently, they announced that iOS 8 would have a built-in app to collect all of your health info in one place. Then there was the announcement of the partnership with Mayo Clinic and Epic Systems. This generated even more headlines.  I saw all ...

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Without a doubt, the death of American veterans as a result of the VA waitlist debacle is tragic and unacceptable. The Obama administration must move quickly and deliberately to fix the underlying problems and restore faith in the agency. If these issues were common throughout the VA network of hospitals and clinics, it might make sense to consider dramatic, earth-shaking alternatives like moving veterans to private providers and shuttering the ...

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The health care IT space is possibly the most exciting and dynamic industry in the United States right now. Health care is going through a total transformation driven by massive regulatory change, the consumerization of health care and the important shift from a system that manages sickness to a system that manages health. Underlying all of this change is the software that runs large health care organizations: specifically, the big EMR ...

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A pivotal moment in the U.S. health care system is taking shape. Physicians across the U.S. are wondering what their role will be in this new health care landscape that is being shaped by legislation (from the Affordable Care Act and from meaningful use), by social media, and by technology advancements. It’s an existential moment. Physicians are wondering if we are knaves, pawns, or knights in this chess game called the ...

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My 87-year-old father broke his hip this past weekend.  He was in Michigan for a party for his 101-year-old sister, and fell as he tried to put away her wheelchair.  The good news is that he’s otherwise pretty healthy, so he should do fine. Still, getting old sucks. During the whole situation around his injury, surgery, and upcoming recovery, one thing became very clear: Technology can really make things much easier:

There is a recent and interesting piece in the Wall Street Journal by an orthopedic surgeon, Dr. Craviotto, about the maddening aspect of forced mandates and bureaucratic requirements in medicine that seem to have very little to do with actual medical care and more about hoops through which we must jump that seemingly lead to nowhere. While I do find the bureaucracy of medicine in the United States insane versus the Canadian ...

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The practice of medicine is an art based on science. – Sir William Osler This was famously stated over 100 years ago by Dr. Osler, the father of modern medicine and the physician who laid the foundation for professionalism in health care.  In this vein, a panel of experts from Boston-area hospitals and elsewhere recently convened to attack the question, “What needs to change to get doctors back to the patients?”  While the ...

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I'm feeling meaningfully used today. Once again, we are faced with another set of administrative hurdles, boxes that need to be clicked, tasks that need to be completed, all in the name of demonstrating that we are meaningfully using the electronic health record in which our practice and the federal government have so heavily invested. An "eligible professional summary" arrives in my email, with lots of bars with lines, and green checks ...

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You may have already seen them -- medical scribes hunched over tablets in hospitals and doctors’ offices, working away like Kim Jong-Un’s omnipresent cadre of note takers (though in this case, they’re actually getting things done). Recently, this piece about the phenomenon was making the rounds in my corner of the Twitterverse. In a conversation with a reach so high that it at one point drew in Dr. Farzad Mostashari (former National Coordinator for ...

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