Dr. Lisa Rosenbaum has an excellent piece in the NEJM entitled "Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine."  In essence a review of Dr. Robert Wachter’s book, The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, it deals with the ever increasing intrusion of the digital-industrial medical complex on the practice of medicine.  Bottom line: Electronic health records ...

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I have recently discussed imperatives of patient-centric health care, creating patient engagement, and potential value of various digital health technologies. Apart from these considerations are those involving roles of stakeholders and barriers they face in adopting technologies and optimal models of adoption. Not lost in the technical, regulatory, and clinical issues required to be addressed are ...

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I have a love-hate relationship with the electronic health record (EHR). To be precise, it's 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages. I've been in practice long enough to straddle the transition from paper ... to even more paper (thanks EHR, you're the ...

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I peeked. Several months ago, I met a 60-year-old woman with shortness of breath. Her hospital stay was a whirlwind. She had lost weight, and a test detected her stool had blood in it. This was an ominous sign. Within a few hours, she underwent a colonoscopy that revealed she had colon cancer. The colorectal surgery team whisked her away from my general medicine team. I soon left that hospital for ...

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There are three visions of peace in the seemingly never ending, but really rather brief, Israeli-Palestinian perpetual crisis. One peace features two independent countries living in collaborative harmony on a piece of land approximately the size of New Jersey. Another peace yearns for a messianic Jewish state stretching from the blue Mediterranean shores to the Jordan River, and possibly beyond. The third and final peace is expected to materialize after ...

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I admit that on one level hearing and reading about the many complaints from physicians about the changes in health care that make their daily practice steadily less productive, less enjoyable and less satisfying along with insights into all the reasons why our system is dysfunctional is helpful in at least knowing my pain is widely shared. Maybe it’s the simple act of venting that bonds us to some small degree, ...

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I recently read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.”  The article states that, despite massive public funding of electronic health records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who purchase their systems. We are talking about gag clauses that prevent criticism by ...

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emr Modern electronic health records (EHRs) have become the norm in U.S. health care -- nearly 80 percent of office-based physicians use them, up from 40 percent in 2009, according to federal data. But while adoption is up, satisfaction has plummeted. In 2010, about 61 percent of physicians liked their EHRs (were satisfied or very satisfied, according to periodic AMA surveys). This dropped ...

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unnamed Heath care documentation is done for three reasons:

  1. health care delivery (that’s the obvious one)
  2. regulatory compliance (checking all the boxes our government and payers think are important)
  3. malpractice avoidance (no one wants to get sued)
These three categories actually apply to every task we do in health care, but let’s confine this discussion to documentation. Note in the accompanying figure, our three basic health care work ...

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The health information technology (HIT) world has been hit by a watershed event like no other. The Department of Defense (DoD), widely respected for its indiscriminate generosity to contractors, has awarded the most coveted prize in recent HIT memory: the Defense Healthcare Management Systems Modernization (DHMSM) contract. And the winner is ... Leidos, the contractor formerly known as SAIC. A couple of years ago, when the race for ...

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