I order pregnancy tests on men. In fact, I do it pretty frequently. Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since. Despite this, I still order pregnancy tests on men. Perhaps ...

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One of the biggest topics today in the health care field is that of meaningful use.  Meaningful use is defined as using certified electronic health record (EHR) technology to improve quality, safety, efficiency, and reduce health disparities.  The promise is that meaningful use will help improve patient and provider communication and increase care coordination while maintaining the privacy and confidentiality of patients. However, serious questions are emerging about whether this is ...

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I know a wise old forester. Ask him any question and he'll answer, “Well, now, it depends on what you want.” “Should we clear this underbrush or just leave it?” It depends on what you want. I realize this can explain any choice we've made: that is, we have what we have because, at some level, that's what we want. In that light, let me discuss electronic medical records. EMRs can be wonderfully ...

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We’ve got a long way to go before information technology solutions at the frontlines of health care fulfill their enormous potential. The suboptimal, clunky and cumbersome design of most IT systems is responsible for much misery among physicians and nurses on a daily basis. Part of the problem is that hospitals and clinics have rolled out these solutions rapidly and somewhat haphazardly to fulfill meaningful use requirements and gain much-needed ...

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I was at a dinner meeting for our hospital last week, and before everyone went in to sit at their tables and hear the evenings’ speeches, there was some time for the usual networking over wine in the reception room. I got chatting to an established local primary care physician, a respected member of the hospital staff who has been in practice for over 30 years. He’s quite a presence and a ...

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I was dining at a friend’s house recently after a long day in the hospital. He has just bought a beautiful new home with his rapidly expanding family, and like anyone who has just moved into a new house, his spare time is invariably spent working on getting everything in order and undertaking small upgrades to make the new place as perfect as possible. He’s quite DIY-oriented (unlike myself) and was spending a lot of ...

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A long time ago in a galaxy far, far away ... what an uncannily accurate description of how it feels to practice in our very own “modern” health care system. In a world brimming over with exponential tech advances -- supercomputer smartphones with user interfaces an embryo could master, an open Internet backbone that connects us across continents and cultures -- our health care universe languishes with software that’s ...

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Software has opinions. No, I’m not talking about opinions on the next presidential election or opinions about flossing before or after brushing. Software has opinions about how data should be displayed, opinions about users’ comfort with the mouse, even, in some cases, opinions about what you should have for dinner (see your local on-demand food ordering service). We tend to view software as a tool that is either good or bad. ...

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The promise that information technology holds for health care is, quite literally, amazing. So far, it has enabled us to get rid of paper charts (not to mention the age-old problem of illegible doctors’ handwriting), negated the need to trawl through mountains of files to find old clinical data, and introduced much-needed safety improvements such as medication alerts. But anyone practicing at the frontlines of medicine over the last few years ...

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This past summer an article in USA Today talked about Regina Holliday’s efforts to make the medical record more easily and promptly available to patients, so it becomes as a tool patients use as they engage in co-managing their own care. Her cause is just, and her story is compelling, so I was dismayed at the pushback saying: Not so fast. There are lots of errors and ambiguities in the record, ...

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