A few months ago, I spent 15 minutes filling out a detailed health data form at the doctor’s office. The paper form contained multiple questions about my health, family history, medications and basic demographic information. I assumed that an administrative specialist would code it into the practice’s electronic medical record (EMR) to be put to use. So it came as a surprise when I spent another 5 minutes reviewing the ...

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Have you ever encountered an intrusive, insistent popup decision support screen while trying to take care of patients? Found yourself stuck in a dead end electronic hallway without egress? A situation where you had to choose an option that was inappropriate for your patient just to exit the screen? This is the situation with my local medical institution's "DVT Advisor," a mandatory decision support screen for all patients. DVT Advisor was implemented ...

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Do I value the privacy of my health information? What do you mean? That if I email my doctor about an embarrassing symptom, only my doctor will read it? That only my doctor, my nurse and I have access to the information in my electronic medical record, including notes on our confidential conversations, prescriptions and test results? That my local drug store doesn't sell information about me to pharmaceutical companies? That if I ...

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If you are a CEO or COO of a health care organization, and your IT people have been trying to get your attention, it’s time to have a serious sit-down with them. If they haven’t been trying to get your attention, it’s time to have an more serious sit-down with them, complete with charts and graphs and arrows on fip charts. Here’s why. Remember in November it was revealed that the Target retail ...

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It started with a dead laptop. For the first time in more than 3 years I felt like a doctor again. I had forgotten what it was like. Having neglected to plug in my laptop the night before, it was without power. (Without power!) An opportunity for an uprising, of consciousness if not full revolt. For the first 1½ hours of clinic I entered each exam room without the weight of the ...

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A version of column was published in USA Today on January 19, 2014. Over half of physicians today use electronic medical records, thanks to the federal government spending more than $22 billion dollars incentivizing providers to transition away from paper charts.  Supporters of digital records, including President Obama, say they improve patient care and reduce health costs.  Having navigated a transition from paper charts to electronic records in my own practice, ...

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With the growing demand of patient demands, change in healthcare delivery with Affordable Care Act, physicians are asked to adapt to these changes rapidly. In order to be efficient and provide this level of care to patients, the use of digital technology in medicine has grown dramatically. New platforms for integrating medical care and digital technology have been developed to enhance doctor patient communication. Digital technology encompasses a broad range of ...

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I had had a long day yesterday, starting with a trip up the interstate to Columbia to meet with other medical chiefs from around the state of South Carolina to discuss the issues that affect the practice of psychiatry in the mental health system today. We had struggled with the electronic medical record, Medicare paybacks, e-prescribing, CPT coding, content of notes, billing time, and motivating our medical staffs to accept the ...

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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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