Through Dec. 15, federal regulators will accept public comments on the next set of rules that will shape the future of medicine in the transition to a super information highway for electronic health records (EHRs).  For health providers, this is a time to speak out. One idea:  Why not suggest options to give leniency to older doctors struggling with the shift to technology late in their careers? By the government's own estimate, ...

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The "necessity-burden monster" are words of my own choosing, and does not reflect any authoritatively-stated or generally-accepted health care paradigm.  It is, for me, an apt summation for how the progressive stages of the administrative side of health care have become a degeneration to the original intention of keeping medical records: to assist in patient care. What it has undergone, particularly in the last twenty years or so, and when compared to the ...

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In a recent post Rocky Bilhartz outlined some of the challenges health care providers face when working with software. Health care providers are spending more time in the digital world and less time interacting with patients. The problem of less patient contact, in part, accounts for their complaints leading to the desire to streamline repetitive tasks so they can get back to why they really choose to be ...

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Venture Capitalist Fred Wilson had a great post a while back titled, "Bootstrap Your Network With A High Value Use Case." He points out that the initial value proposition for Waze (the community-based traffic and navigation app acquired by Google) was simply to help drivers that like to drive too fast identify speed traps. But it of course quickly expanded way beyond that and now provides a lot more value ...

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Last week I was playing golf with some friends. The Boston area has been having a bit of an Indian summer, and we are lucky to still be getting out there (long may it last). The conversation during one of the holes turned to health care information technology, when my friend, who is also a physician, told me about his experiences with a (certain famous) new electronic medical record that’s just been installed in their ...

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In Hollywood In the classic film, The Day the Earth Stood Still, an alien spaceship lands in Washington, DC, and delivers an alarming message; people of the earth must cease their internecine hostilities or face total annihilation. To prove their power, the aliens cause all electrical devices on the planet to stop working for 30 minutes. It's a pretty impressive show of force. In the office At 8:45 a.m. yesterday, despite the absence ...

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Health care remains one of the few services that require people to have a face-to-face interaction to obtain access. But more and more consumers are questioning that reality, and change is on the way. In January 2015, the Centers for Medicare & Medicaid Services (CMS) issued a new provider reimbursement code for non–face-to-face health care services for patients who have chronic medical conditions. A new CMS code may ...

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Statistics suggest that physicians are now spending a minimal amount of time in direct patient care, shockingly as little as 10 percent of their day. This proportion of time that physicians (and nurses) actually spend interacting with patients has been shrinking year by year. There’s the need to communicate with other members of the expanding health care team, increased bureaucratic requirements, and over the last several years -- the need to ...

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“It’s going to be ugly today” was my colleague’s assessment at 6:30 a.m. Wednesday morning, when the electronic medical record failed to launch, the Internet could not be accessed, pagers and phones could not connect, and a recording on the helpdesk line noted, “Systems are down, and there is currently no estimated time of resolution.” So we waded into fourteen hours of practicing medicine without computers. This was not good. Patients’ ...

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As more hospitals move to electronic health records (EHRs), many physicians have started writing about their growing discontent with the new systems. Authors have declared that EHRs are poorly designed, inefficient, lead to over-billing, and are downright dangerous. When my supervising physicians gripe about this, I mainly nod along to avoid conflict. But I have a confession to make: Most physicians currently in training love electronic ...

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