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Implementing An EHR: 5 Quick Tips

Dr. Jay Anders, the CMIO of EHR vendor MED3000, offered a few tips during a Medical Group Management Association (MGMA) session on implementing an EHR successfully:

1. Make a clear communication pathway. Everyone needs to know what’s going on, from the physicians to the receptionist.

2. Clearly identify the needs of every physician who is going to use the EHR. The needs of an internal medicine doctor aren’t the same as a dermatologist. Make sure the EHR meets those needs.

3. Get a physician champion for the EHR who will be responsible for talking about the project to peers and answering questions, and be the first person to implement it. Pay that person for his or her time spent in championing duties.

4. Some people need more time than others. Don’t let a resistant doctor stop the implementation. Develop a plan for dealing with resisters that includes how you’ll respond to negative comments, how to implement other colleagues despite the resister, and how to sell the benefits of the EHR to the resister.

5. Expect the EHR implementation to be time-neutral. Most EHRs don’t save time; their value is in improved patient care and documentation, which leads to better reimbursement.

*This blog post was originally published at ACP Internist*

Medicine, Car Racing, And Teamwork

There’s an article in the Oct 20, 2010 issue of the Journal of the American Medical Association (JAMA) which discusses surgical team training and teamwork in the operating room.

Most surgeons have crews or individuals in the operating rooms they prefer to work along side. Things just go smoother. We work more as a team, more as one.

Why? Personalities. Communication styles that work well together. Skills that compliment. Each person knows and does their job, not trying to do someone else’s. Each knowing that even the smallest task is important to the whole.

Ideally, we could create teams like this at all times in the operating room. In reality, its not so easy. Change in personnel happens. Team members get sick, so there is great need for crosstraining and flexibility. Personnel (including surgeons) need to be able to work with these changes.

I know currently the comparison is to racecar teams that change the tires, etc. with great efficiency or the aviation industry with their checklists. While we should learn from these industries, we must not forget that medicine is far more diverse. Surgeries are not all the same. The cars are. Read more »

*This blog post was originally published at Suture for a Living*

When I Really Felt Like A Doctor

PalMD over at The White Coat Underground recently asked: “When did you really feel like a doctor?” Interesting question that I could answer in a number of ways.

While I didn’t know it at the time, I felt like a doctor around 4am during my first night on call. I was an intern on the hematology ward at Texas Children’s Hospital. I was fresh out of medical school, I had chosen a residency known for its mind-boggling volume, and the kids were really sick. I had hit a point where I simply couldn’t keep up with what was in front of me. I stole away into the 6th-floor stairwell in the Children’s Abercrombie building, put my face into my hands, and began to cry.

My first call night was a metaphor for my career. I had no idea at the time that the idea of simply keeping up would be a theme that would follow me through my training and into my day-to-day work.

While I can’t remember the last time I cried at the hospital, I continue to struggle with input. I work to keep up with inbound information and professional social dialog. How I handle information or how I appear to handle it defines me as a physician. Harnessing this attention crash through technology will represent a major defining moment for the next generation of physicians.

*This blog post was originally published at 33 Charts*

An “Eyetracker” To Keep You Awake At The Wheel?

While some car manufacturers already offer systems which can alert drivers who are dozing off, the feature is rare, and tends to be quite expensive when offered.

Now, researchers at the Fraunhofer Institute for Digital Media Technology have developed the Eyetracker, which provides this functionality at a lower cost and can be installed in any car. The Eyetracker’s cameras track the driver’s eyes, and the system will sound an alert if it determines that the driver is falling asleep. Read more »

*This blog post was originally published at Medgadget*

Improving Health Literacy By Healing The Doctor-Patient Relationship

When it comes to understanding medical information, even the most sophisticated patient may not be “smarter than a fifth grader.”

In one of the largest studies of the links between health literacy and poor health outcomes, involving 14,000 patients with type 2 diabetes, researchers at the University of California San Francisco and Kaiser Permanente found that more than half the patients reported problems learning about their condition and 40 percent needed help reading medical materials. The patients with limited health literacy were 30 to 40 percent more likely to experience hypoglycemia — dangerously low blood sugar that can be caused if medications are not taken as instructed — than those with an adequate understanding of medical information.

Now, federal and state officials are pushing public health professionals, doctors, and insurers to simplify the language they use to communicate with the public in patient handouts, medical forms, and health websites. More than two-thirds of the state Medicaid agencies call for health material to be written at a reading level between the fourth and sixth grades.

A new federal program called the Health Literacy Action Plan is promoting simplified language nationwide. And some health insurers, doctors’ practices, and hospitals have begun using specialized software that scans documents looking for hard-to-understand words and phrases and suggests plain-English replacements. Read more »

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

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How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

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Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

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