How natural language processing can help EHRs

An excerpt from Too Big to Ignore: The Business Case for Big Data (Wiley and SAS Business Series). Unstructured and semi-structured data is, by its nature, largely text based. Even numbers are often surrounded by words, like an article on a company’s stock. This section describes some of the tools that trans­late what is often ...

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We recently marked the third anniversary of the passage of the Affordable Care Act by reflecting on the positive changes it has brought about and by mulling over the multifaceted challenges that stymie our efforts to build more accessibility, equity, quality, safety, and cost-effectiveness into one of the most complex healthcare systems in the world. Reining in healthcare costs, a central element in the reforms we seek, is inextricably linked to ...

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It feels like part of me is dying.  I am losing something that has been a part of me for nearly 20 years. I bought in to the idea of electronic records in the early 90′s and was enthusiastic enough to implement in my practice in 1996.  My initial motivation was selfish: I am not an organized person by nature (distractible, in case you forgot), and computers do much of the ...

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EMR designers: Your actions can kill The ICU hummed as the tech guy waltzed in at two in the morning.  A key designer of the EMR himself, the night shift nurses had his mobile and were not afraid to use it.  There was a problem reconciling Mr. Jones med list after his emergency bypass surgery that evening.  Patients first. The next one in the door was the young CEO ...

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If I’m learning anything from working locum tenens jobs, it’s that there is a wide, mind-numbing variety of electronic medical records (EMR) systems in place around the country.  At my primary work site, we use Med-Host.  Like every EMR, it has some bugs. But having seen other systems in other places, it’s clearly a Cadillac product in a great, big car lot of Yugos. I’m not going to disparage other systems ...

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I hate saying I told you so.  But "patient engagement is a physician-patient communications challenge and not an HIT (health information technology) challenge.” Just take a look at the Mayo Clinic’s patient portal experience which was discussed at a HIMSS 2013. The headline: "Mayo Clinic struggles to meet stage 2 meaningful use thresholds for engaging patients." Always innovating, the Mayo Clinic some three years ago introduced a web-based portal to share ...

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I’m well aware that a good fraction of the people in this country spend their lives furious at the New York Times. I am not one of them. I love the Grey Lady; it would be high on my list of things to bring to a desert island. But every now and then, the paper screws up, and it did so in a big way in its
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Iinspired by the VA's big bold step of going OpenNotes, I wrote a blog post titled OpenNotes in geriatics: 6 awkward concerns. It was written in the spirit of just about everything I write: to share the nitty-gritty complexities of what I find myself navigating in geriatrics, to bring attention to medical issues that older adults and PCPs struggle with, and to try to bridge the rhetoric-reality ...

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The progeny of the iPhone and the iPad will change the shape of your institution — and your balance sheet. One of the more striking images, to me, out of the online spew in the last few months was from the inauguration. It was a wide view of an inaugural ball. There was the president waltzing with the first lady, and a crowd of several hundred watching them. What was striking ...

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What patients want from mobile apps Dear mobile health app developers, We—patients and caregivers—need your help to reduce the demands of self care. Mobile health (mHealth) apps have enormous potential to lessen our burdens. But our needs are often only loosely related to what clinicians and/or the evidence expect us to do. Most mobile app developers have ignored this fact by designing tools that primarily reflect the imperatives of ...

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