Hospitals are commonly thought of as the safest place to be for sick people. Patients have around-the-clock access to skilled care teams. Their vital signs are continuously monitored. A physician stops by every morning to check on them. While it all sounds safe, a hospital can be a very dangerous place to be. Here are four frightening risks hospitals pose, along with their causes and some easy-to-implement solutions that could save hundreds ...

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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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The primary debate in health care reform this past year centered on insurance coverage. The next great debate will focus on the cost of providing health care. For decades, the way we’ve paid doctors and hospitals has driven up health care costs. And while the pace of health care spending has slowed the last four years, it continues to rise faster and more noticeably than improvements in U.S. health care outcomes. The reason is not ...

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During my year as a chief resident, I have the privilege to attend on the general medicine service for 8 weeks. I recently completed 4 weeks and, as expected, found myself in an entirely new realm of patient care and accountability. I would be remiss without recalling a few of the pivotal lessons and poignant moments that stand out. Transitioning from resident to attending inevitably results in greater scrutiny. Despite my best ...

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The medical and health app market is growing rapidly, there’s no question about it. One as yet unanswered question though is how to regulate this emerging industry. This is something we’ve talked about before in a viewpoint published in JAMA Dermatology as well as on iMedicalApps. While it is still early on and we will in many ways have to see which approach is most suitable, its clear that some way ...

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Brain death is death. This is one of the definitions of death. Even in Texas. Because brain death is death, a do not resuscitate (DNR) order or invalidating a DNR are both meaningless, because you don’t do procedures on dead bodies. This is why taking someone off a ventilator who is brain dead is not homicide, assisted suicide, or even following a DNR, it is simply the cessation of forcing air ...

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Now that consumers can generally make an efficient health insurance purchase at Healthcare.gov and most of the state-run exchanges, we can finally get to the real question. Are the healthy uninsured going to buy it? The big health insurance changes Obamacare made to the individual and small group market were arguably done in order to get everyone, sick and healthy, covered in a more equitable system. To be clear, no one I know ...

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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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Most physicians love the profession.  Our medical students and residents want to care for patients, interact with patients and help those patients.  For most physicians, the joy of medicine occurs at the bedside and while investigating patient problems.  The joy does not extend to scut work (defined in the free dictionary as “trivial, unrewarding, tedious, dirty, and disagreeable chores”). Now who defines scut work? Back in the 70's, we would define scut ...

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I was just recently in Guiyang, the capital of the Guizhou province in China and had a chance to visit the Huaxi District People’s Hospital (HDPH), one of the largest “secondary” hospitals in the province.  Like the rest of China, it has been gripped by the construction boom, recently opening a new surgery center and revamped medical facilities.  They had a terrific EHR from a local vendor -- probably more ...

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