CMS has paid out over $21 billion dollars in incentive payments to providers and hospitals who have successfully attested under the EHR Incentive Program (i.e. meaningful use). With that much money out the door, you can bet that Congress is watching closely to ensure that those dollars are only going to people who really have met the requirements. One way that CMS is monitoring meaningful use is by conducting audits ...

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With the advent of information technology in health care, patients and providers alike have begun to feel a cultural angst about what this means for the future of medicine.
As a recently minted MD with a keen interest in health IT that began with working on Google Health six years ago, I’m decidedly on the forward-looking end of the spectrum in the physician community. I think decision-support algorithms have the potential ...

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Lessons learned during an unplanned EMR downtimeA guest column by the American College of Physicians, exclusive to KevinMD.com. On a Thursday in April, my practice upgraded its electronic health record to the next version, the “latest and greatest” with more features, as well as compliance with meaningful uses 2 through infinity. That was the good news. The bad news was that it meant that our EHR ...

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Fifteen minutes. Give or take. That’s about how long a patient typically spends with a primary care doctor during an office visit. If you’re lucky enough to be healthy, maybe that visit comes once every year or two.  Or if you’re less healthy, maybe every few months. In either case, it’s not a lot of time. Not a lot of time to share all the relevant developments. Not a lot ...

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It’s rare for doctors to turn out en masse for a public protest. But that’s what happened at “Doccupy” in Contra Costa County, California in 2012. A group of safety net physicians testified before county supervisors -- in what they only half-jokingly called “Doccupy” -- that the cumbersome move to electronic health records (EHRs) had taken an enormous toll on patient care. The doctors saw half their usual number of patients. ...

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I’m back at it again, talking about my continued love/hate relationship with EMRs. From my conversations with doctors at different hospitals in our region, it seems that most docs appear to be falling into the “hate” column. Meanwhile, I’m still chugging along with the EHR that’s been installed in my office. And while it works just fine for the needs of a 3 physician single-specialty outpatient practice, it’s hardly the ...

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I’ve been thinking about EMRs, electronic medical records, lately. It’s a subject, despite some professional experience, I don’t feel particularly close to. In fact, if anything, they are a source of consternation. As an industry insider, I see them as an expensive albatross around our collective neck. As a human centered design adviser, I see them as an encumbrance for both providers and patients. And, as a patient I see ...

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What health care can learn from Katzs Delicatessen Sometime during the last year of the second millennium, I wrote my last letter in response to the last letter I have ever received. It’s been email ever since. I don’t recall making a conscious decision to stop writing letters. It just happened. I cannot pinpoint the exact date when my work memos, agendas, proposals and various notes, disappeared from my desk ...

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Technology finds its way into our lives not so much in big flashy ways as little ones. Oh, I can do this a little bit faster now, isn't that cool? Wow, isn't this convenient? Oh, isn't this a huge risk to my privacy? Oftentimes, when I start talking about Linux or scripting or the command line or any number of tech subjects that seem increasingly esoteric, I get blank stares from ...

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Our privacy is eroding. Some of this erosion is our own fault -- we post to Facebook, Twitter, and other social media with reckless abandon. Some is the nature of modern communication -- electronic trails are just as easy to find as paper trails (if not easier). Some of the privacy erosion really doesn’t bother me so much -- if Target knows that I buy a lot of Cheerios, I’m ...

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