A few months ago, I was on call and admitted a 65-year-old man to the intensive care unit for a flare of his chronic obstructive pulmonary disease (COPD). Although he had only gotten to the point of being unable to speak full sentences between gasps for breath for only a few days, his story started two months earlier when he had gradually started retaining water and getting more short of ...

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Drivers are distracted klutzes and computers could obviously do better. Self-driving cars will make all of us safer on he road. Doctors have spotty knowledge and keep illegible records. EMRs with decision support will improve the quality of healthcare. The parallels are obvious. And so far the outcomes are disappointing on both fronts of our new war against human error. I remember vividly flunking my first driving test in Sweden. It was early ...

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Attend any biotech or health informatics conference and one thing becomes clear: the scarcity of physicians. Entrepreneurs, businessmen, angel investors, and software engineers swarm these conferences -- and their encompassing companies -- all the while the imperative persona in this realm remains tied up behind a dysfunctional EHR or in an overbooked operating room. Why? Certainly, inculcating these dynamic players in the health care space is integral to the successful evolvement ...

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“There’s an app for that.” The phrase became so popular with the advent of smartphones that Apple even trademarked it. There are currently 3.8 million apps available on Android devices and over 2 million available to Apple iPhone users. Does that mean that we’ve reached a limit on new and useful apps that can be created? Absolutely not. Especially in the medical world, it seems as if there’s so much room to ...

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Wouldn't it be cool if ... ? Wouldn't it be better if ... ? Wouldn't it be much easier when we see patients if ... ? How come we can't ... ? It seems like every day, someone in our practice comes up with an idea for a way to do something better:

  • From our front desk staff who check patients in, and have to deal with a multitude of electronic systems for registration, ...

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I am a frequent traveler and spend a lot of time in a number of different cities. The one I’ve currently been spending the most time in is a place, quite frankly, I’m crazy about: New York City! Anyone who writes a lot is usually also by default, a keen observer of people, and there’s no place better to do this than a busy, crowded city. There’s an interesting habit that ...

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As a system, we don't invest as much time in understanding the broader context of the patient in front of us. The before/after factors that we don’t notice have a far-reaching impact on care. Recently, I shadowed a patient through a day procedure at an endoscopy center from the time that the nurse checked her weight to the time that she was discharged. Let's call her Nancy. She was 82 years old ...

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Say we met ten years ago. And you asked me: Would health care delivery be more complicated in the future? I would've said, "No, it would be simpler!" Pointing you to technology trends, I would’ve told you that health care transactions will indeed become more automated, much simpler. Repeatable administrative tasks would be tech-enabled and algorithm-driven. My company started life in billing claims for doctors. Back then I was quite sure billing would ...

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Modern technology needs to do better. This is the message delivered by every CEO after every Silicon Valley scandal in recent memory. This time, they should really do it. Medicine can show them how. Let's have the professionals building our future abide by industry-wide standards, just as doctors do. As both a startup founder and a physician, this idea makes intuitive sense to me. Drawing on my experience treating patients and running ...

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When I was a cardiology fellow back in the 1980s, I learned about a variety of early tools for evaluating heart health that had been displaced by the modern standards of electrocardiography (ECG, or EKG for the Deutschephiles) and echocardiography. One such technique – ballistocardiography – stuck with me, and may be making a comeback. Ballistocardiography is based on the observation that the mechanical action of the heart leads to subtle ...

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