Click, click, click, “Hello, how are you today?” Click, click, click, “How long have you had a sore throat?” Click, click, click, “Have you had a fever?” Click, click, click, “Have a seat on my exam table, please.” Click, click, click, welcome to my day.  Let me introduce myself, I’m a professional clicker.  I used to be a member of a highly respected and sought after profession; a doctor.  The modern world of government/insurer ...

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In a recent New York Times article, “Redefining Medicine with Apps and iPads,” Katie Hafner describes a “generational divide” in medicine. On one side sits the younger generation, at ease navigating EMRs and diagnosing disease with the assistance if digital apps. On the other side of this presumed generational divide, she describes the older generation, worried “that the human connections that lie at the core of medical practice ...

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Venture capitalists (VCs) ... are a combination of professional gamblers and loan sharks. The secret to success is pure luck and ruthlessness, and when the combination works and the ball lands on the exact number on the spinning roulette, venture capitalists make lots of money. -Margalit Gur-Arie, via KevinMD.com The tone of this article, Why venture capitalists shouldn’t try to solve health care, exemplifies what is wrong with healthcare. In ...

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Imagine this scenario: A CEO stands in front of the board at a crucial juncture in corporate history, and says:

Members of the board, as you can see from the financial statements before you, we have had a reasonably good year. What!? You don’t have the financial statements in front of you? I have them here. I mean, I think I have them here. Where are they? Let me check with ...

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Healthcare innovation companies are just beginning to understand technology challenges that come with engaging patients with chronic diseases in care management and care transition. Many of healthcare IT vendors assumed that a simple access to portals with half-baked information and  fragmented medical records will do the trick. Boy… were they wrong! For the past twenty years, the HIT industry has focused on developing software solutions exclusively for healthcare providers. These companies ...

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I work at several hospitals and each uses a different electronic medical record system. When I switch from hospital one to another, I obviously have my favorite EMR systems and my not so favorite EMR systems. In the previous post, I was using the EMPOWER charting system, which I liked for its simplicity, but disliked because of the layouts of the charting interface and some of the macros ...

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“This note was produced using [mega-brand] medical dictation software. While every effort has been made to insure accuracy, errors may still exist.” Really? What kind of doctor would admit in a medical chart to being too lazy or incompetent to produce an accurate record? A lot of them.  Dictations are easy to read if you are willing to confound legibility and accuracy.  Dictation software is relatively cheap, and with the continued profusion ...

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As medicine moves forward in its most technologically advanced era yet, we continue to struggle with basic concepts such as record keeping.  The medical record is vital to the care of the patient.  It tells the story of each patient’s journey through the medical system.  The idea of centralizing all pertinent medical information is, in theory, a step in the right direction.  In utopia, there would be one medical record ...

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Not long ago, Secretary of Health and Human Services Sibelius and US Attorney General Holder issued a stern warning to healthcare providers who are using electronic health records (EHRs).  The federal officers maintain there has been an alarming increase in the charges to Medicare in institutions where EHRs have been implemented, and they warn that those behaviors will be treated as “fraud,” an illegal gaming of the system to increase ...

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Does your doctor use a computer instead of a paper chart? Chances are that she does. The rate of adoption of electronic medical records (EMRs) over the last three years has been very steep. The main driver of this is a government subsidy from a part of the 2009 Stimulus Act (called the HITECH Act) that incentivizes doctors and hospitals to make the conversion to electronic record-keeping. The push has been ...

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