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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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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