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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Blockchain technology has the potential to dramatically transform health care delivery by facilitating data exchange between providers and electronic health record (EHR) systems. A decentralized and transparent platform, blockchain technology provides an authenticated platform that applies a consensus-driven approach to facilitate the interaction of multiple entities through a shared ledger. For the health care sphere, blockchain is simply the sharing of medical information through EHRs across numerous hospital systems that ...

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Physicians have a love-hate relationship with the electronic health record (EHR). On the one hand, doctors know they can't provide the best possible medical care without them. And on the other, today's EHR systems are cumbersome, clunky and slow physicians down. Indeed, there's much to love and much to hate about today's EHRs, alongside a variety of ways to address the problems they create. One solution may lie in blockchain, the technology currently ...

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Eons ago, there was a television show where a non-human character would yell out, "Warning, warning," when he sensed imminent danger. The series was called Lost in Space where we were entertained by a set of quirky characters on a cheesy set. We loved that stuff. It’s hard to imagine today’s millennials and younger folks being transfixed, as we were, with the deep television dramas of our day. Who could ...

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I can’t help myself from telling patients how things really work in health care. But I feel they have a right to know. When I see new patients their jaw usually drops when I sit down with them next to the computer with a stack of papers held together with a rubber band or a gigantic clamp and with yellow sticky notes protruding here and there with words like LAB, ER, ...

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It is all too common for a section in a progress note to look something like this:

# Aspiration pneumonia:
  1. Continue vancomycin 1 g bid
  2. Continue Zosyn 3.325 g q6h
  3. Follow-up blood cultures
  4. Follow-up sputum cultures
  5. MRSA nares screen negative
  6. Blood cultures negative
  7. Discontinue vancomycin
Yesterday, a version of this note (lines 1 to 5 to be precise) had my name on it. Today, it is signed by someone else. Read it ...

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At the start of the transition to electronic health records (EHRs), I was totally on board as one would expect of a millennial doctor. I, along with my fellow millennials, grew up alongside the internet. We can type with our eyes closed, navigate pop-ups in a jiffy and intuitively know how to manipulate electronic charts to serve our purposes. But, I did find myself in a unique position in the millennial ...

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Hypertension, or high blood pressure, is a leading cause of heart disease and stroke that has escalated to alarming rates in recent years, affecting nearly 1 in 3 adults in the U.S. In an attempt to reduce its prevalence, the Eighth Joint National Committee (JNC-8) released a set of hypertension management guidelines. However, various concerns arose regarding the recommendations and as a result, the American College of Cardiology (ACC) and ...

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