I am not sure of the date or time of death. However, I am reasonably certain of the cause. Death was by electronic data and formatting. The victim was the time-honored physician's progress note. To be sure, these notes, even the now "ancient" written ones, were far from perfect. And they were often illegible. Shortcuts such as "as above" or AVSS (all vital signs stable) littered the pages of the ...

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Certain medical stories are irresistible to the popular press: ICD-10 external cause codes that are ridiculous (W61.43XD, pecked by a turkey, subsequent encounter) or medical practices using their electronic health records in a way that increases their revenue. A recent headline was eye-catching, as headlines are meant to be, “Report finds more flaws in digitizing patient files.”  The New York Times reported that the Office of Inspector General (OIG) ...

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I passed the 60 mark more than a year ago and since then have been more aware of my limitations: some joint aches, getting tired easier, more need to rest and longing for a slower pace in my everyday routine. Meanwhile, general medical practice is speeding up and increasingly shedding its limitations. As information expands exponentially, doctors need not only to keep up with the information that reaches them directly, but ...

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Patient portals are very much the future of health care. Having easy access to ones’ medical history, diagnoses, and test results, seems like such a natural thing that it’s hard to imagine that only a couple of decades ago medical information was regarded as private for the physician’s eyes only. Of course, the Internet and technology revolution has taken this concept to a whole new level. Health care organizations across the ...

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As a physician, not a day goes by without a new acronym I need to look up, a new policy I need to follow, another box I need to click or another criteria I need to meet -- and this is just to keep up. While the health care picture and its various unknowns loom ever larger in the news, and health information emails overstuff my inbox, it is worth ...

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The governor of Vermont, Peter Shumlin, devoted all of his annual speech to the problem of drug addiction. On the national news, Shumlin points out the link between prescription painkillers and death, and he calls for treating opiate addiction as a medical problem no different than cancer. The White House praised the governor’s position. Meanwhile in another part of Washington, I’m involved in the federal effort to link the law ...

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One of the spinoffs of being an oncologist is that you do not to take the world for granted.  Each morning, I walk around the yard and smell the morning breeze. I am thankful for my children, my wife and my own health.  I am thrilled, if occasionally skeptical, to have the opportunity to pay taxes in a country that I love.  So, who would believe I would take our ...

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Besides the importance of physician happiness when using an EHR, using design principles that maximize user intuition and presentation of relevant information, there is one aspect of health care information systems that should never be overlooked: patient safety. Scot Silverstein, MD, blogging at Health Care Renewal as InformaticsMD, frequently brings to light issues surrounding health care IT implementations that compromise patient safety.  Reading his posts should be sobering and concerning to ...

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I was talking to a colleague recently about his practice, and remarked that he was still keeping a paper medical record. Without hesitation, he made it clear that he not only liked the paper record, but he positively dreaded switching to an electronic record. He said sadly that he thought it was inevitable that he would be forced to switch, but hoped that the day would be far into the ...

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I recently stumbled across a blog post by Dr. Jay Parkinson, an entrepreneur and founder of Sherpaa, who reflected on a recent private breakfast with New Yorker and best selling author Dr. Atul Gawande.

The question posed by Gawande: Can technology be a change agent for health care? The inevitable answer is yes, with one important caveat. It’s not the technology that will change the practice of medicine, it’s the doctors who ...

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