It is all too common for a section in a progress note to look something like this:
# Aspiration pneumonia:
- Continue vancomycin 1 g bid
- Continue Zosyn 3.325 g q6h
- Follow-up blood cultures
- Follow-up sputum cultures
- MRSA nares screen negative
- Blood cultures negative
- 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 …
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 …
As someone who has been in IT health care supporting hospitals, radiologists, and specialty surgeons, I’ve seen the struggle from just about every angle when it comes to the problems with health care technology. One of these struggles that continue to be a problem for myself, our patients, and our physicians are the imaging CDs that patients bring in.
Sometimes the patient brings in a disc that is found to be …
The third year of medical school is when a student experiences the frustrations of medicine firsthand. Once, my team admitted a transfer patient from another hospital to treat a condition that was ravaging the patient’s lungs. But before we could act, we needed to rule out a dormant infection; if our patient was unknowingly infected with tuberculosis (TB), giving our first-line therapies could lead to a disseminated infection — even …
One of my readers, Natalie, wondered about my thoughts about the digital pill.
My initial reactions were similar to several of those who were interviewed for the article. The digital pill, which provides electronic information to confirm whether someone has ingested the medication, has great potential to become a tool of coercion. Aripiprazole (Abilify) is classified as an antipsychotic medication, which is often prescribed to people who have beliefs that machines …
Brain-computer interface (BCI) has been a topic of interest for several decades, and many discoveries have been made. The role of BCI has been monumental and significantly impactful in the field of medicine. It has been gaining much progress in recent decades with inventions such as the encephalophone, in which a person can create music with their thoughts alone, or a patient can move a cursor icon on a monitor …
In about 1990 we got our first computer. I say “we” because my husband and I shared a desktop which I used infrequently. I mostly used it for word processing, and the Internet was very young. At the turn of the millennium, my children were using computers, and they were limited to 1 hour of computer time a day, which was on a shared desktop. By 2001, I was communicating …
Tele-empathy is not being empathetic over the phone. It is not crying in the sad parts of your favorite TV show. It is not beaming empathetic thoughts magically across time and space. No, tele-empathy is a technology. I should rather say, it’s a group of technologies recently being created to increase the empathy of health care providers. “This is rich,” you might say coming from an industry that brought us …
An exchange between former Vice-President Joe Biden and EPIC CEO Judy Faulkner at a Biden Cancer Initiative event has again elevated the discussion of patient access to their medical records.
You can read the discussion on Politico. However, Biden’s main point was that patients needn’t justify their claim to their own EHR records.
In fairness to Ms. Faulkner, they did express a common view: medical records are too complex for …
I have wanted to be a pediatrician since I was eight years old. Growing up, my favorite book was the large medical encyclopedia that sat on the bookshelf in our den. My life has been planned around that singular goal, each step predetermined and in a very specific order. I have thoroughly enjoyed practicing medicine over the last 17 years — first as a primary care pediatrician, then for the …
With the Department of Justice announcement of the $155 million dollar eClinicalWorks settlement (including personal liability for the CEO, CMO and COO), many stakeholders are wondering what’s next for EHRs.
Clearly, the industry is in a state of transition. eCW will be distracted by its 5-year corporate integrity agreement. AthenaHealth will have to focus on the activist investors at Elliott …
A patient comes into the ER complaining about throbbing migraines after falling off her bicycle; thus, the physician quickly orders an X-ray, complete blood count, and asks the nurse to schedule the patient for an MRI of the head and neck in case both those tests come back inconclusive. As an ER scribe, I saw many conditions where the physician would quickly do a physical exam, and then use a …
During residency, one of my patients brought a tape recorder to his appointment. It was a big bulky old tape recorder, that was antique technology ten years ago. He was older and wanted to record his appointment so he could remember every detail. His children often called him and wanted an in-depth report of all of his medical visits. He decided he would audio-record his appointments and send the tape …
The business value of medication adherence tools is coming into focus. For years, I remarked that, while we could create a case for why adherence was the right thing to do, we had great difficulty creating the right financial incentives to move these programs from curiosity to scale. That is changing now with the collision in the marketplace of new payment models and exorbitantly priced pharmaceutical products.
The poster child for …
I am an email junkie and spend more time than I would like to admit on emails every day. I start my day by looking at emails, and I end every evening reviewing emails. And yes, I spend time during the day checking the computer for pertinent emails that need my attention. I think many physicians are of the same ilk.
According to Alexandra Samuels, who is the author of Work …
Startups looking to partner with health systems: This list is for you.
So often, it seems like new technologies being developed for health care don’t address the areas of largest need. We sat down with nursing leaders at the University of California, San Francisco (UCSF) to get a sense of what clinical problems could be best addressed by technology.
The following list was compiled from interviews with Sheila Antrum (president and senior …
Virtual visits are increasingly the rage amongst forward-thinking healthcare providers that want to jump on the telehealth band wagon. Extending the office visit across distance, using the same technology we use to keep in touch with loved ones (videoconferencing such as Skype and FaceTime), is a safe and logical way for providers to venture into a new tech-enabled world that may still be scary for some.
One way to think of …
I order pregnancy tests on men. In fact, I do it pretty frequently.
Now before you go and question my professional competency, let me assure you that I went to a good medical school. I also completed a four-year residency in emergency medicine at a top-notch residency program. I was board-certified less than one year after finishing and have maintained that status ever since.
Despite this, I still order pregnancy tests on men.
Perhaps …
Last week I was playing golf with some friends. The Boston area has been having a bit of an Indian summer, and we are lucky to still be getting out there (long may it last). The conversation during one of the holes turned to health care information technology, when my friend, who is also a physician, told me about his experiences with a (certain famous) new electronic medical record that’s just been installed in their …
I have a love-hate relationship with the electronic health record (EHR).
To be precise, it’s 90 percent hate, 6 percent love. The missing 4 percent? That would be the percentage of time spent on the phone with tech support trying to figure out which order set I have to use to input percentages.
I’ve been in practice long enough to straddle the transition from paper … to even more paper (thanks EHR, you’re the …
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