I find myself spending close to an hour on the computer each morning at the hospital. I spend this time dutifully looking up vital signs, labs, recent radiology or pathology results as well as many other valuable pieces of information about each of my patients. I watch as my colleagues frantically record values, while making sure to point out important trends and gross abnormalities. When we round, there is always a ...

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Doctors see firsthand the toll that today’s increasingly stressful society takes on patients: Engineers, office managers, teachers, you name it. Work demands have increased, as has multitasking. Pressures outside the workplace add additional stress. Often, parents chauffeuring children to multiple activities must also care for aging parents with increasing needs. Electronic devices, always in hand or close by, command our attention (due to work or personal needs, sometimes simultaneously). Finding a ...

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To listen to all those desperate to reform health care, you get the impression that physicians are pretty horrible people. We are all sexist, greedy, money grubbing tyrants who will perform unnecessary tests and procedures just to make money. We don't care about quality or cost. We are killing off 250,000 patients every year with our ignored "errors." We purposely keep our patients in pain, or we addict them to ...

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An exchange between former Vice-President Joe Biden and EPIC CEO Judy Faulkner at a Biden Cancer Initiative event has again elevated the discussion of patient access to their medical records. You can read the discussion on Politico. However, Biden’s main point was that patients needn’t justify their claim to their own EHR records. In fairness to Ms. Faulkner, they did express a common view: medical records are too complex for ...

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How does the EHR drive burnout? Let’s count the ways. By understanding this, we can develop countermeasures to lower the impact and reduce the risk of physician burnout. We’ve all seen the studies that show that for every hour we spend with a patient, we spend two hours on administrative work, and we take hours of work home with us each night. But as we’ll see, it’s not all just about ...

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Electronic health records (EHR) have been used for several years. It is the form that physicians use to login sensitive information about their patient. Security and confidentiality of such delicate, valued protected health information (PHI) has historically been a concern, and rightfully so. Over the course of a few years, hacking on broad scales have been common occurrence and PHI is considered a high priority target by such malicious actions. An answer ...

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As many of you know, much of my focus has been on how we can improve health care information technology, and build on the systems that we currently have to make them more user-friendly and less cumbersome. At the crux of the problem is the issue of the disproportionate amount of time they take to navigate and how they turn the noble and personable art of being a doctor, into ...

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A patient of mine recently came to see me in a follow-up appointment after an emergency department visit. He had been working out at the gym, on a hot day, after he had skipped breakfast, and after his usual routine he felt extremely lightheaded. Everyone told him he looked "white as a sheet", and a physician who was at the gym told him he must go to the emergency department. In ...

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Mr. X. is a man in his 80s who was cured of his cancer. The question remains: at what cost? The biologic therapy and radiation which eradicated the cancer left him with the inability to swallow and need for permanent PEG tube. Due to overall frailty and multiple comorbidities, he never graduated from the SNF and continues to reside there today. I inherited his care after he completed his definitive treatment in ...

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Earlier this week, as I write this, our office lost a skirmish against technology. It was my procedure day, where lucky patients file in awaiting the pleasures of scope examinations of their alimentary canals. A few will swallow the scope (under anesthesia), but most will have back-end work done. We are a small private practice equipped with an outstanding staff. We do our best every day to provide them with the ...

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