It is with regret that meaningful use legislation has barreled down the path of insanity. As a primary care physician, I don’t see how 700+ pages of rules and proposals mean any bit of relevance to my clinical practice anymore. As the attrition continues regarding eligible providers, it is leading primary care physicians towards the junction point of going off the grid entirely or being enslaved by horrible EHRs forever. I ...

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Two modest kiosks far in the back of a cavernous HIMSS 2015 exhibit hall symbolized two separate streams of the patient engagement effort as filtered through health information technology (IT). One featured a Bluetooth-enabled toothbrush paired with a personalized video game to teach kids to properly care for their teeth. Call that approach, “enabling compliance.” Nearby, another kiosk showcased a computerized questionnaire to help patients understand their treatment goals and true ...

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The government has doled out nearly $20 billion in incentive payments since 2010 for its meaningful use program in order to nudge physicians towards adopting electronic health records (EHR). U.S. hospital systems and physician practices pay billions annually to EHR vendors in order to qualify for those meaningful use incentive dollars and prevent penalty payments in the future. EHR adoption has modernized the practice of medicine in innumerable ways. However, documentation ...

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shutterstock_31681267 On Monday March 30, 2015 our Greenway PrimeSuite electronic health record had a system-wide failure at the level of the Edgemed Computer service center in New York State. It meant that I was back to using pencil and paper to interview patients and record the answers and physical findings. With much trepidation, I began seeing patients with two sheets of white blank ...

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acp new logoA guest column by the American College of Physicians, exclusive to KevinMD.com. So far, 2015 has been a busy year for reflecting on the use of electronic health records (EHRs). CMS just released its proposed rules for meaningful use stage 3. One might say that “MU 3” supports the belief that the sequel is never as good ...

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A recent piece in the New York Times profiled a young man with a remarkable medical history, and an equally remarkable approach to sharing it. I think it raises some profound issues regarding the self-monitoring movement and the “ownership” of patients’ health information, both of which have the potential to change our traditional practices in a big way. The guy -- Steven Keating -- is not your average Joe. He is a ...

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shutterstock_84146302 I drank the Kool-Aid early.  We installed our first EHR in 1996 with me doing the lion’s share of pushing and pulling.  While I’d ultimately turn my back on this passion, I had a number of notable accomplishments before walking down my road to Damascus.

  • Within a year of implementation, our practice became one of the top installations for our vendor.
  • Within two years, ...

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The nightmare sickens me. A small child trusts a man to protect her, take care of her, and shield her from harm. The man, for incomprehensible and useless reasons, neglects her unto death. For me, when I think of Germanwings flight 9525, I am haunted by the photo of a single tiny girl, taken in the last days of life; the obliteration of that perfect life’s potential. Waste, tragedy, evil. In the ...

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On March 20, 2015 the stars aligned to produce four simultaneous events that will never again coincide during the life of human civilization. The first three, the vernal equinox, a total solar eclipse and a new supermoon, were brought to us by the stars themselves, and the fourth one was thrown out there by the government. The regulations for meaningful use stage 3 were finally published. Meaningful use of electronic health ...

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Sometimes, after crafting an important or complex plan of care with a patient, I say: “Let me type all this into the computer so that, in case I run into that big bull moose up on Vaillancourt Hill on my way home tonight, the next doctor who sees you will know what we were thinking today.” Patients sometimes squirm or laugh nervously at that, but then they usually indicate understanding and ...

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