I was dining at a friend’s house recently after a long day in the hospital. He has just bought a beautiful new home with his rapidly expanding family, and like anyone who has just moved into a new house, his spare time is invariably spent working on getting everything in order and undertaking small upgrades to make the new place as perfect as possible. He’s quite DIY-oriented (unlike myself) and was spending a lot of ...

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A long time ago in a galaxy far, far away ... what an uncannily accurate description of how it feels to practice in our very own “modern” health care system. In a world brimming over with exponential tech advances -- supercomputer smartphones with user interfaces an embryo could master, an open Internet backbone that connects us across continents and cultures -- our health care universe languishes with software that’s ...

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Software has opinions. No, I’m not talking about opinions on the next presidential election or opinions about flossing before or after brushing. Software has opinions about how data should be displayed, opinions about users’ comfort with the mouse, even, in some cases, opinions about what you should have for dinner (see your local on-demand food ordering service). We tend to view software as a tool that is either good or bad. ...

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The promise that information technology holds for health care is, quite literally, amazing. So far, it has enabled us to get rid of paper charts (not to mention the age-old problem of illegible doctors’ handwriting), negated the need to trawl through mountains of files to find old clinical data, and introduced much-needed safety improvements such as medication alerts. But anyone practicing at the frontlines of medicine over the last few years ...

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This past summer an article in USA Today talked about Regina Holliday’s efforts to make the medical record more easily and promptly available to patients, so it becomes as a tool patients use as they engage in co-managing their own care. Her cause is just, and her story is compelling, so I was dismayed at the pushback saying: Not so fast. There are lots of errors and ambiguities in the record, ...

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As the New Year arrives and health care continues its rapid evolution, one of the most critical challenges that we face is the interaction of information technology with frontline clinical medicine. If you were to ask, at the start of 2016, any physician (or even nurse) what their biggest daily frustrations are -- most would list health care IT at or near top of the list. And it’s not just ...

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It’s been a long day in the psychiatry clinic. Seeing patients is never dull, and each interaction is meaningful in its own way. From the moment they walk into my office to the moment they leave, I try my best to be fully present with the patients sitting in front of me. That means listening to every word, watching every nuance of body language, hearing every concern -- both spoken and ...

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You may be forgiven after reading some of my articles for thinking that I’m somehow "anti-health care information technology." It’s a subject that I’ve written a lot about over the last couple of years, mainly because I feel passionately that our use of information technology at the frontlines of health care needs to drastically improve. But let me start first by making a confession: I love information technology. I am just ...

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"It was a dark and stormy night." My computer didn’t catch fire while typing the previous sentence. No alarms were triggered warning me about the quality of such opening. I wasn’t prompted to select subjects and predicates from drop-down lists. I typed the entire sentence, letter by letter, not at all dissimilar to its first rendering back in 1830. Computer software, in general, and Microsoft Word in particular, magically removed the ...

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Dear Santa, I’ve been a very good doctor all year. I have checked all my boxes and aced all my meaningful use requirements. This year, I’m not asking you for anything fancy. I just thought you might be able to instill some kindness and good will into the people who designed the user interface of my EMR. Maybe, with your help, they would come to see how a few minor tweaks ...

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