From MedPage Today:

  1. 'Meaningful Use' Still on Target During Shutdown. The government shutdown may be slowing or halting a number of health-related activities, but federal incentives for electronic health records aren't one of them.
  2. Inappropriate Antibiotic Use Still High. Despite years of persuasion and publicity, antibiotics are still drastically overprescribed for two common complaints -- sore throat and bronchitis.
  3. Fecal Transplant, Now ...

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I recently supervised a new intern as she conducted a patient interview. Following procedure, the intern reviewed the patient’s electronic medical record (EMR) and checked his lab results. She noticed that his cholesterol was high, and he told her that he had stopped taking his atorvastatin due to a recent trip to the Dominican Republic. “It’s no problem,” my intern replied. “We’ll get you back on the medication.” She began to ...

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EMRs are not designed for patient care. Is there anyone working in health IT who can honestly say that he or she never heard this statement being made hundreds or thousands of times? Is there any clinician actually working with patients and EMRs who can state that such thought never crossed his or her mind? This includes health IT evangelists and physicians spearheading IT initiatives at the most excellent of ...

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The promise and the peril of big data in health careThere was a memorable scene in the movie "The Graduate" from 1967. You may know it or have heard of it, when the older man turns to the college graduate and says the future is all about one word: "plastics." Well, plastics may have been then, but this is now. And the core themes I keep hearing these days there are two central ...

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The medical board of the state of Oklahoma recently sanctioned a physician for using Skype to conduct patient visits.  A number of other factors add color to the board’s action, including that the physician was prescribing controlled substances as a result of these visits and that one of his patients died.  This situation brings up several challenges of telehealth -- that is, using technology to care for patients ...

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I have a vague recollection, a memory shrouded in mist, where I pondered what seemed like a radical question: What would a health record look like if my only concern was patient care?  This was a radical question because in my previous life I was an electronic health record aficionado.  I was good at EMR, which meant that I was really good at finding work-arounds:

  • How can I work around the requirements for ...

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My institution recently switched from its home-grown electronic medical record (EMR) to EPIC, a system for which many great things have been promised. Indeed, it is a considerable improvement over the past one. A number of hopes have been pinned on the latest-generation EMRs, not the least of which is the idea that finally, with this newest generation of tools, a nexus can be created and sustained among comparative effectiveness ...

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A Bank of America ATM can figure out who you are and how much money is in your account in seconds. It can spit out cash in virtually any currency from nearly any spot in the world -- even if you’re a Chase customer. It’s a technological convenience we’ve all come to expect. Hospitals and doctors' offices are starting to replace hard copy patient records with computerized heath systems. Some U.S. ...

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Electronic health records (EHR) systems are expensive. Really expensive. In fact, there have been reports of these systems causing significant revenue decreases or business interruptions -- such as Henry Ford Health System in Michigan reporting that implementing EPIC was a direct cause of their 15 percent net income decline in 2012. Using a free EHR system is a tempting alternative for many independent doctors or small practices. But are there ...

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As I travel around the country, working in the trenches of various hospitals, I’ve been struck by the number of errors made by physicians and nurses whose administrative burden distracts them from patient care. The clinicians who make the errors are intelligent and competent -- and they feel badly when an error is made. However, the volume of tasks required of them in a day (many of which are designed ...

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