shutterstock_186139613 Right now, there are two patients in every room. One is made with flesh, bones, and blood. One is made with a monitor, a mouse, and a keyboard. Both demand my time. Both demand my concentration. A little over two weeks ago I wrote the short story "Please Choose One." I posted it online. The response it generated exceeded anything I could ...

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I am a clinician and a clinical trialist. Medical research in some form or another (performing it, consuming it, reviewing it, editing it, etc.) occupies much of my time. Therefore, you can imagine my excitement while watching Apple’s product announcement when they introduced a new open source software platform called ResearchKit. Apple states ResearchKit could “revolutionize medical studies, potentially transforming medicine forever.” ResearchKit allows clinical researchers to have data about various diseases ...

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Andy McAfee is the associate director of the Center for Digital Business at MIT’s Sloan School of Management. He is also coauthor (with his MIT colleague Erik Brynjolfsson) of the 2014 book, The Second Machine Age: Work, Progress, and Prosperity in a Time of Brilliant Technologies, one of my favorite books on technology. While he sits squarely in the camp of “technology optimists,” he is thoughtful, appreciates the downsides of IT, and ...

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shutterstock_224345509 I have a unique perspective as a physician. Having traveled to many hospitals in the past two years, working as a locums emergency physician, I can comment on a variety of issues with a reasonable amount of experience. One of those issues is EMR, or electronic medical records. I have spent plenty of time writing about this in the past, and I ...

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shutterstock_154083233 Please choose one: The three words blink in front of me on the computer screen. Please choose one: Patient is-Male     Female  I click FEMALE. I watch as the auto-template feature fills in the paragraph for me based on my choices. Patient #879302045 Patient is: 38-year-old female status post motor vehicle accident. Please acknowledge you have reviewed her allergies, medications, and past medical history. I click YES. Have you counseled her about smoking cessation? I click NO. A little, animated icon of a ...

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Despite the well-known rollout problems for hospitals and clinics across the nation, there are many palpable and welcome advantages to using electronic health records. Chief among these are the ability to access the chart from anywhere, rapidly search for information needed, and reducing the centuries-old problem of illegible doctors’ handwriting.  But with the good comes the bad, and in these still relatively early stages of health care information technology adoption -- ...

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The other day I ordered a CT scan with contrast on a patient with an apparent mass on his neck. I explained about the need to get a blood test to make sure his kidneys could handle the iodine contrast. Because our lab was closed, I had to print a requisition for him to bring to the hospital lab. Printing a requisition from our EMR is a multi-step process that involves ...

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First off, this is the first time I have typed an official response to a blog post: "Dear health IT: Please understand our frustrations."  You might think, hey aren’t you a millennial, shouldn’t you be blogging non-stop?  Like doing everything from my taxes to baking with my smartphone?  No, not really; besides residency doesn’t make it very feasible either. Yet, the need to respond to Dr. Leap’s blog post was ...

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Remember the Latin phrase “Primum non nocere”? It means “First, do no harm.” Most of us physicians committed to it when reciting the Hippocratic Oath, back when we were first embarking on our careers in medicine. Sadly, today’s technology threatens this sacred physician-patient relationship. Electronic health records (EHRs), although much-needed, have created perverse, unintended consequences for the patient experience. To be clear, EHRs are inherently good.  They’re the backbone of better-coordinated care, ...

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It has been quite a year.  Between 3 main hospitals, 2 major medical institutions and 3 major healthcare networks, our practice has been on 3 different echocardiographic reading platforms, 3 ECG reading platforms, and 8 different electronic health record systems including 4 instances of Epic alone. I am typically enthusiastic to a fault about new technologies and, time after time, have rushed in, often where angels feared to tread.  I ...

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