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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As the New Year arrives and health care continues its rapid evolution, one of the most critical challenges that we face is the interaction of information technology with frontline clinical medicine. If you were to ask, at the start of 2016, any physician (or even nurse) what their biggest daily frustrations are -- most would list health care IT at or near top of the list. And it’s not just ...

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It’s been a long day in the psychiatry clinic. Seeing patients is never dull, and each interaction is meaningful in its own way. From the moment they walk into my office to the moment they leave, I try my best to be fully present with the patients sitting in front of me. That means listening to every word, watching every nuance of body language, hearing every concern -- both spoken and ...

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You may be forgiven after reading some of my articles for thinking that I’m somehow "anti-health care information technology." It’s a subject that I’ve written a lot about over the last couple of years, mainly because I feel passionately that our use of information technology at the frontlines of health care needs to drastically improve. But let me start first by making a confession: I love information technology. I am just ...

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"It was a dark and stormy night." My computer didn’t catch fire while typing the previous sentence. No alarms were triggered warning me about the quality of such opening. I wasn’t prompted to select subjects and predicates from drop-down lists. I typed the entire sentence, letter by letter, not at all dissimilar to its first rendering back in 1830. Computer software, in general, and Microsoft Word in particular, magically removed the ...

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Dear Santa, I’ve been a very good doctor all year. I have checked all my boxes and aced all my meaningful use requirements. This year, I’m not asking you for anything fancy. I just thought you might be able to instill some kindness and good will into the people who designed the user interface of my EMR. Maybe, with your help, they would come to see how a few minor tweaks ...

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I spent the past month working on an inpatient medicine team at our tertiary care hospital. As a referral center, we often care for incredibly complex patients who require multiple consulting services. One of the most vexing parts of caring for our patients is attempting to track their care through many previous hospital systems. Unless a patient is both extremely vigilant about his or her medical care and highly health literate, ...

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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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