A computer algorithm learning how to play StarCraft like a champ may raise some eyebrows, but when algorithms start to give the skills of a trained physician a run, job security becomes a futile construct. An algorithm now diagnoses melanoma as well as a dermatologist: A consolation for the dermatologists, though: Folks across the hallway -- the radiologists and the pathologists -- are feeling the heat as well. ...

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One of the topics I write most about and have also done a considerable amount of consulting work on is improving and optimizing health care information technology. I hate to say it, but after a few years of doing this, I’m starting to despair a little from what I’m seeing. It’s a question I never thought I’d ask: But will health care IT ever really get to where it should ...

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In 1949, my maternal grandparents left everything and everyone they knew -- a happy family, a comfortable home, a thriving medical practice -- to travel further across the Earth than any of their family ever had before, to come through Ellis Island, and to trek to the Mayo Clinic so my grandfather could become a pioneering anesthesiologist. Twenty-one of my aunts, uncles, and cousins have since followed in their footsteps and ...

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Compare the following two versions of the same medical history: Version 1 CC: chest pain Mr. Smith is a 57-year-old white man who comes into the office today for the first time with a complaint of chest pain. He states he has been in generally good health in the past, though he has smoked about 40 pack-years and admits to not exercising much, other than occasional games of golf. He has trouble keeping ...

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As I've listened to the confirmation hearings for cabinet nominees, I’ve realized that no one with health care IT expertise has been identified by the transition team. I continue to ask all my colleagues about any contact they’ve had with anyone advising the new administration. So far, no one has been asked anything by anyone related to health care IT. At this early time in the administration, it’s important to offer ...

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Another year passed by, and I was going to write about my wishes for the New Year as a hospital doctor. But then, remembered that I did something very similar a couple of years ago. I went back and read over my wishes and found that they are identical to my wishes now! That’s not to say we haven’t made some great progress but — as anyone in health care ...

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The Centers for Medicare and Medicaid Services (CMS) EHR Incentive Program -- also known as meaningful use (MU) -- initially provided incentives to accelerate the adoption of electronic health records (EHRs) to meet certified program requirements.  Many physicians were mandated to change over to electronic records at the cost of tens of thousands of dollars.  Electronic records have never been shown to improve patient care or outcomes with statistical significance, ...

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Anyone with a computer or smartphone is well aware of the incessant alerts that flash across the screen, often accompanied by a beep or exclamation point. The alert may be for an upcoming appointment, a reminder of an acquaintance’s birthday -- or a just-announced sale at your favorite online retailer. How many of these alerts are really important? It’s easy to ignore a media news flash -- but what if you ...

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The notion began early in computer science class during Jason's freshman year. The professor had noticed a certain elegance and zeal in his work and suggested medicine. That was in the days of the giants when clinicians were tied to such clunky programs as meaningful use and PQRS. In this antiquated milieu, Jason cut his teeth on basic health care architecture. In those prehistoric years, there still remained a bias toward ...

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I remember the disdain some of the EHR trainers had for their trainees back when our hospital system “went live” several years ago. Of course, this disdain was tempered by their knowledge that if docs weren’t so computer illiterate, or the user interfaces of the EHR systems weren’t so awful, or if the EHR software wasn’t so bug-ridden, their jobs wouldn’t exist. So they soldiered bravely on, undaunted by grumpy old ...

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