The EHR report card 2014: Has it gotten better?A guest column by the American College of Physicians, exclusive to KevinMD.com. A little over two years ago in this blog, my “EHR report card” evaluated the effect of the electronic health record (EHR) on my practice. I thought it would be interesting to see how things have changed.  As in 2012, I will not identify my ...

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In their current form, most (if not all) EHRs kind of stink. I don’t speak from direct experience, as I’ve held off buying and implementing a system to date. But I’ve never heard any of my colleagues say they love -- or even really like -- their EHRs, and I’ve asked many. The most ardent supporters state that they've gotten used to their systems (usually after years of tribulations) and ...

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With the recent discovery of the ShellShock vulnerability affecting a large number of computers, the question comes up again: How secure is medical data? Thanks to the federally mandated push to transfer medical data from paper charts to computer databases, most if not all of this data is now fertile ground for hackers. As pointed out in this article medical data is more valuable to hackers than stolen credit cards. ...

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Who is blocking EMR interoperability? You are. The Senate Appropriations Committee has defined a new transgression perpetrated in the committee’s expert opinion by vendors of certified EHRs, as well as “eligible hospitals or providers.” Since the committee has no data or evidence of any kind that this transgression is actually occurring, it requires the Office of the National Coordinator for Health Information Technology (ONC) to embark on a ...

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Why do so many seemingly great technologies fail to penetrate the health care system? I hope the following five answers shed some light on the realities of technology adoption in health care. 1. Many new technologies don’t address the real problem Tech entrepreneurs often take a backward approach to invention. They start by discovering a nifty technology. Later, they figure out how people can use it. This technique often teaches entrepreneurs a tough lesson: Technology ...

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Over the last year I’ve written a lot about the problems with health care IT and how we need to get better. Unfortunately, unlike other aspects of our life where information technology has actually made life easier, in health care the user experience been nowhere near as smooth. IT solutions, including electronic medical records, are for the most part slow, inefficient and cumbersome. They cause a great deal of frustration ...

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5 things EMRs should learn from social media As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular ...

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One of the most important tricks of the trade that I learned in medical school was what some might have considered a little throwaway bit of advice. During my psychiatry clinical rotation the preceptor advised that, when applying the stethoscope to the patient’s back, one should rest the other hand gently on his or her shoulder. Human touch was important. It would relax the patient and convey subconsciously a sense of ...

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The Health Information Technology for Economic and Clinical Health Act of 2009 committed to the expanded adoption of health information technology, expecting electronic health records (EHRs) to transform medical care while promising dramatic improvements in quality, efficiency and safety.  Five years and $25 billion later, the results have fallen short of expectations, and there are multiple reasons for our disappointment. First, EHRs were designed to document the provision of health care ...

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A few days ago a colleague of mine was inching south through the mother of all traffic jams: 60 straight miles of construction work on I-95 just south Washington, DC. The three-lane highway was jammed. Route 1, which runs parallel to I-95 was also jammed. Cars were stalled in the middle of the highway having run out of gas from waiting so long. He looked at the map on his phone ...

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