The idea of starting over with computerized electronic health record (EHR) systems and doing them right as mentioned in a previous post has struck a resonant chord. Unfortunately designing an EHR that works may be a fantasy, due to one huge hurdle that would have to be overcome first. But it is fun to imagine an alternative universe where EHR systems were patient-centric instead of being ...

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Over the past 5 to 10 years, hospitals and physician offices have been in a mad dash to implement electronic health records (EHRs) in order to meet governmental regulatory requirements.  Now that most projects are either complete or well on their way, what are we doing with all of the data that EHRs promised to generate? From my experience as a physician at a large academic medical center with one of ...

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Go into any hospital today and notice that between every great nurse and patient sits a computer terminal. The quantified health movement has created the great digital divide, between the patient and everyone else. The nurse of old used to actually touch the patient. No more. Now, they wheel in a computer console, sit down and record the digital output of the wired up patient, every vital sign, every drug order or ...

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The EHR report card 2014: Has it gotten better?A guest column by the American College of Physicians, exclusive to KevinMD.com. A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed.  As in 2012, I will not identify my ...

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In their current form, most (if not all) EHRs kind of stink. I don’t speak from direct experience, as I’ve held off buying and implementing a system to date. But I’ve never heard any of my colleagues say they love -- or even really like -- their EHRs, and I’ve asked many. The most ardent supporters state that they've gotten used to their systems (usually after years of tribulations) and ...

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With the recent discovery of the ShellShock vulnerability affecting a large number of computers, the question comes up again: How secure is medical data? Thanks to the federally mandated push to transfer medical data from paper charts to computer databases, most if not all of this data is now fertile ground for hackers. As pointed out in this article medical data is more valuable to hackers than stolen credit cards. ...

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Who is blocking EMR interoperability? You are. The Senate Appropriations Committee has defined a new transgression perpetrated in the committee’s expert opinion by vendors of certified EHRs, as well as “eligible hospitals or providers.” Since the committee has no data or evidence of any kind that this transgression is actually occurring, it requires the Office of the National Coordinator for Health Information Technology (ONC) to embark on a ...

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Why do so many seemingly great technologies fail to penetrate the health care system? I hope the following five answers shed some light on the realities of technology adoption in health care. 1. Many new technologies don’t address the real problem Tech entrepreneurs often take a backward approach to invention. They start by discovering a nifty technology. Later, they figure out how people can use it. This technique often teaches entrepreneurs a tough lesson: Technology ...

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Over the last year I’ve written a lot about the problems with health care IT and how we need to get better. Unfortunately, unlike other aspects of our life where information technology has actually made life easier, in health care the user experience been nowhere near as smooth. IT solutions, including electronic medical records, are for the most part slow, inefficient and cumbersome. They cause a great deal of frustration ...

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As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular social media platform functionality) for making them better. 1. Likes. Health care ...

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