A major goal of MIPS is to increase the sharing of information between providers and eliminate so-called data silos. Central to this goal is the implementation of fast health care interoperability resources (FHIR). FHIR allows one EHR to directly query and pull information from another EHR, and is based on the belief that medical charts can be reliably abstracted into resources. All ...

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What if I told you just a few years ago that Amazon — a budding e-commerce startup — would come to disrupt the multi-billion dollar retail industry. I seriously doubt that anyone could have given it a serious thought. At least not in the magnitude that will force a slew of big-box retailers to shut their doors for good. I am sure the same response would have been elicited about Uber and ...

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“Let’s take a look together,” was the start of a virtual clinical assessment that led to a primary care provider and a neurologist diagnosing a patient with Parkinson’s Disease. As the neurologist in that conversation, I had the opportunity to play a meaningful role in delivering my expertise and, most importantly, making sure the patient received the highest level of appropriate care. With telemedicine’s support, both providers - and the ...

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A recent study published in Science, one of the world’s leading academic journals, found that a predictive health care algorithm discriminated against black patients. The tool, created by Optum, was designed to identify high-risk patients with untreated chronic diseases, thereby helping administrators re-distribute medical resources to those who’d benefit the most. But there was a glitch in the algorithm, according to researchers. Rather than ranking the needs ...

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The year is 2050. You enter the room, ready to speak with your next patient, a 60-year-old white male with recent episodes of chest pain when he climbs the stairs to his office. Before sitting down to speak with him, a monitor in the room pulls up his recent lab work and current medications. Your patient note is being filled in, but nobody is typing; the computer is avidly listening ...

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I recently spoke with a colleague who transitioned out of the military in the last year. He was previously excited about his new job opportunity, but now a year later, he tells me, "I hate civilian medicine." I was surprised because he had been excited about the opportunity to teach in a residency program again. He said, “I love teaching, and I love the residents. ...

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“So, if you look at this table, you can see that group X had a small but statistically significant increase in mortality over group Y. What does that tell us? It suggests that maybe there is some signal that intervention A is better than intervention B.” The slide has some table from some journal, and the speaker will then often circle some p-value and talk about the strengths and weaknesses of ...

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Just imagine the following: your assistant invites in Ms. Nichols, who has a migraine, a bad cough, and feels nauseated. You sit down, start talking about the symptoms, see her throat, measure her temperature, pulse rate, inquire more about the headache. In the end, you set up a diagnosis, you write a prescription for some meds, send the patient for some further exams due to the migraine, but ensure her ...

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In the history of medical care, medical records served one purpose and two masters: to record diagnosis and treatment for physicians to refer to and for patients to use to transfer care when they desired. The medical record was a simple 3 x 5 or ledger card in the 1950s. The patient paid directly for care at the time of service. Usually, the physician had a nurse and a spouse ...

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A featured article titled "Death by A Thousand Clicks" addressed some of the serious problems and challenges we still face in the "digitization" of health care. As an early adopter of EHR since 2003 and a self-avowed "techie," I can vouch for the fact that many of the government initiatives in HIT, like "meaningful use," actually made many EHRs worse. Why? Because many of the regulations were being written by ...

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