Your electronic health record may lack vital information Your electronic health record may lack vital information A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com. When you walk into any physician’s office or hospital, computers are everywhere.  By 2013, nearly 70 percent of hospitals had moved away from paper charts and toward electronic health records, or EHRs, and more are making the change ...

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According to IBM, there are 2.5 exabytes of data created every day, and most of it is unstructured. Imagine receiving all the words ever spoken by human beings on your doorstep each and every day. Now, imagine consuming that, making sense of it and trying to keep up with the ever-accelerating pace of data creation each day. As a physician, I experienced firsthand the angst that comes with trying to keep up ...

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Dear ACO General Hospital: Thanks for contacting me about my most recent blog post.  I'm sorry to scare your administration about HIPAA information, but I am equally concerned about that and will always do my best to respect the privacy of my patients.  At your request I hid even more of that information. I know it's kind of embarrassing to have that kind of thing made public, and I am overall ...

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Why is medical IT so bad? A 57-year-old doctor I know is retiring to teach at a local junior college.  He is respected, enjoys practicing medicine and is beloved by his patients; therefore, I was surprised. While he is frustrated by the complexity of health insurance, tired by the long hours and angered by defensive medicine, the final straw is that he can not stand the world ...

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Do EMRs improve patient safety? A debate. “I’m here to say ‘Yes, they can,’ which is different from ‘Yes, they always do,’” says James Moore, MD, president-elect of the California Society of Anesthesiologists (CSA). To the contrary, enthusiasm for electronic medical records (EHRs) is part of a “syndrome of inappropriate overconfidence in computing,” argues Christine Doyle, MD, the CSA’s Speaker of the House. The two physician anesthesiologists (and self-identified “computer ...

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One of the major reasons that health care providers resist implementing an electronic medical record (EMR) system is the belief that using it will decrease provider productivity, reducing the number of patients they can see and therefore reducing practice revenue. However, an EMR that is designed around a streamlined workflow can enable providers to work faster and more efficiently. Having an EHR and vendor that can give you ongoing visibility and ...

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Over the past several years I’ve written about the inadequate state of clinical documentation, which is largely unchanged since the days of Osler, (except for a bit more structure introduced by Larry Weed in the 1970s) and was created for billing/legal purposes not for care coordination. One of the most frequent complaints in my email box these days is a sense that the current record is filled with data, but little knowledge and ...

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It has been 5 years since the passage of the HITECH Act portion of the Affordable Care Act. The purpose of HITECH was "to promote the adoption and meaningful use of health information technology." While the result of this legislation has been the significant increase in the adoption of EHRs, most of the potential benefits of digital technology have yet to be demonstrated. there are multiple reasons for this lack of proof. The ...

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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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