The subject heading of a recent email correspondence read “beware, graphic picture ahead!” Obviously this piqued my curiosity, so, with one eye closed, I scrolled down on my iPhone to a picture of my patient’s tongue, which, truth be told, had a certain “you haven’t seen anything yet quality.” The tongue in question? Maybe some white spots, certainly nothing gruesome, and most assuredly nothing I hadn’t seen before in my 12+ ...

Read more...

Here are just a few of the mouse clicks, key strokes, and computer screens I need to make or navigate to get through my day: Control-Alt-Delete. User Name. Password. Double click on the icon to load the electronic health record (EHR). User Name again. Password again. Schedule. In-basket. Results. Patient Calls. Rx Requests. And that is just to get started. Before I finish my first cup of coffee. Every patient interaction that needs ...

Read more...

Health care providers want their patients to have the best outcomes possible.  They know that for this to happen that the patient must be engaged in managing his or her condition, whether it is an acute or chronic condition.  Patients need to follow the provider’s directions and orders.  If they do not, then the outcomes will be sub-par. For instance, if you the provider give a patient a prescription then they ...

Read more...

We generate it every minute of every day of every week of every month of every year. Data, in countless forms. Of recent and growing interest to a great many people is how this data can be use to improve health (not just sell people more stuff). Wear a FitBit or Jawbone? Amazing source of activity information. Check in on Foursquare? Insight into dietary habits. Post on Twitter? Sentiment analysis around ...

Read more...

Now that Labor Day has come and gone,  I’ve thought about the months ahead and the major challenges I’ll face. 1. Mergers and acquisitions. Health care in the US is not a system of care, it’s a disconnected collection of hospitals, clinics, pharmacies, labs, and imaging centers.  As the Affordable Care Act rolls out, many accountable care organizations are realizing that the only way to survive is to create “systemness” through mergers, ...

Read more...

The question has been raised: Why re-invent the EMR wheel?  What is so different about what I am doing that makes it necessary to go through such a painful venture?  I ask myself this same question, actually. Here’s my answer to that question. What medical records offer: High focus on capturing billing codes so physicians can be paid maximum for the minimum amount of work. What I need: No focus on billing codes, ...

Read more...

A recent article on American Medical News titled "Medical charting errors can drive patient liability suits" led with a case involving a bad outcome after coronary artery bypass surgery. The plaintiff's attorney alleged that the doctors did not review the patient's lab results or x-rays because they did not specific say so in the medical record. The article quoted a defense attorney who said, "By the time [the doctors] are deposed, ...

Read more...

I used to be a big believer in the transformative power of digital data in medicine. In fact, I devoted the past decade of my life to assisting the “movement” towards better record keeping and shared data. It seemed intuitive that breaking down the information silos in healthcare would be the first logical step in establishing price transparency, promoting evidence-based practices, and empowering patients to become more engaged in their ...

Read more...

I had a nice conversation with a dermatologist at a party recently.  He started complaining about the notes he receives from other physicians.  He used terms like piles and piles of junk. Talk to any experienced physician and they will tell you that once upon a time our teachers taught us to write notes appropriate to the situation, not appropriate to the billing system. Several years ago I ranted about the necessity ...

Read more...

"It looks like you've done very well, Mr. Smith." "Thank you, doctor." He left the patient's room and ambled back to the nurses station, legs tired and ankles somewhat swollen.  It had been a long case and now he just had to type his note, send an email message, and review his schedule for the following day.  He sat down at the computer and logged in.  That's when he looked up briefly ...

Read more...

Most Popular