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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Following my latest article on health care information technology, and how tragic the situation has become for physicians, I received a lot of correspondence. As always with articles that express physicians’ frustrations with the current batch of IT systems, there’s typically a lot of sympathy and agreement (although I believe that just nodding our heads and saying how bad a situation is, doesn’t really mean that ...

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Computers, more specifically, electronic health records (EHRs), will someday revolutionize the practice of medicine. In fact, successful computerization of medical care is the most critical step necessary to transform the American health care system from its current sorry state to the 21st-century system of our dreams. It is ironic, then, that today EHRs represent one of the worst problems plaguing medical professionals. At this point, many physicians would say that ...

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With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs. Clearly, the industry is in a state of transition. eCW will be distracted by its 5-year corporate integrity agreement.    AthenaHealth will have to focus on the activist investors at Elliott ...

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I’ve spent a lot of time writing about the suboptimal nature of electronic medical records and what we need to be doing better. At their best, health care information technology systems can make finding patient medical data unbelievably quick and easy. However, at their worst, they take up an unacceptable amount of physicians’ time and also dumb down medicine, reducing our patients’ stories to rows of meaningless tick ...

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When a new doctor joined our clinic, she spent a week learning our electronic medical record. She had used two other systems before, so she was no stranger to EMRs, but that’s how different they can be. That’s crazy! EMRs should be like cars, which range from the likes of Smart, Mini Cooper, and Skoda to Mercedes Maybach, Rolls Royce, and Porsche. They range from simple to sophisticated, from nimble city cars ...

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At HIMSS, I listened carefully to payers, providers, patients, developers and researchers. Below is a distillation of what I heard from thousands of stakeholders. It is not partisan and does not criticize the work of any person in industry, government or academia. It reflects the lessons learned from the past 20 years of health care IT implementation and policy making. Knowing where we are now and where we want to be, ...

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"There is no document of civilization which is not at the same time a document of barbarism." - Walter Benjamin, Theses on the Philosophy of History It is 1940, and the Nazi horror is bearing down on Europe.  France has fallen, and refugees are streaming out, fleeing to safety through neutral states and America.  Walter Benjamin, a Jew, and a German philosopher, joins a small group being guided through southern Spain with ...

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When I began my tenure at the University of Florida, the departure of a colleague left a very large inflammatory bowel disease practice that involved a lot of work both in and outside of clinic, just as the electronic healthcare record became mandatory. One unanticipated consequence of EHR is that physicians have to review everything before it is final in a patient’s chart. Thus, I spent countless hours in the EHR ...

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Computerized physician order entry (CPOE) is something that every physician up and down the country will be familiar with. For anyone non-medical reading this, it’s the process by which physician orders are now placed in nearly all U.S. hospitals. As little as five years ago, most hospitals were still using pen and paper to place medication, laboratory, radiology and all other orders. Being able to do this now by computer ...

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