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The Future Of Health Care Requires Considerable Typing Skills

I always loved to type.  It started in high school with typing class.  We were told that typing was critical for college term papers.  I liked it so much that I took advanced typing.  It was myself and 12 girls with Farrah Fawcett hair.  Heaven.

Fast forward to 2011.  My interface with the medical record is my fingers.  Most of my communication flows through my hands.  I complete the core of my documentation in the exam room.  Fast documentation of information at the outset of an encounter allows for meaningful, eye-to-eye dialog during the latter part of the visit.

Those who can’t type have a different experience with their EHR.  Sure there’s voice recognition but when pressed they wish they could make a sentence instantly flow onto the screen.  Two colleagues this week, one from Barbados and another from the UK, Read more »

*This blog post was originally published at 33 Charts*

Sometimes Little Changes Can Add Up: The Extra Work Of The EMR

“I estimate these changes to your charting work flow will take only five minutes.”

Five minutes is fine if it happens for only one patient. But when it is multiplied by as many as forty patients in a day, the multiples get impressive. Five minutes x forty patients = 200 minutes (more than 1.5 hours a day).

Minor five-minute changes to administrative charting requirements aren’t so minor, especially when you add more time for quality assurance reporting or pay-for-performance initiatives. Suddenly huge swaths of time from a doctor’s opportunity to take care of their patients. We need more care time and less data entry time. Doctors must insist that we not become data entry clerks.

Increasingly, I see the data entry burdens of regulatory health care documentation requirements falling on doctors. On first blush, this seems logical because only doctors (or very capable, highly trained surrogates) understand the nuances required to make potentially life-altering adjustments to the electronic medical record. But when new administrative documentation requirements are added to doctors and other care providers, it Read more »

*This blog post was originally published at Dr. Wes*

Is The Increased Patient Safety Of The EMR Worth The Inefficiency?

With all the talk about how EMR/EHR resources will make practicing medicine better, faster and safer, I learned of an unintended consequence that is probably under appreciated these days. Hospitalists are being asked to admit more and more patients because, for primary care doctors, when they compare EMR medicine with the old way of  doing things, EMR is just too time consuming to make it worth their effort.

That’s right, hospitalists are admitting more patients because the primary care doctors find their time costs for navigating their new EMR, which they bought to qualify for EHR stimulus funds under ARRA, are simply too great.  In a business where efficiency must prevail, EHRs Read more »

*This blog post was originally published at The Happy Hospitalist*

Can Physician De-Skilling Be Attributed To The Use Of EMRs?

Turns out there is an unintended consequence of many of the current efforts to standardize the way doctor’s practice medicine.  It is called de-skilling.  De-skilling can occur when physicians and other providers try to adapt to standardized, new ways of doing things.  Examples of such standardization include clinical based care guidelines, electronic medical records (EMRs), Pay for Performance (P4P), Patient Centered Medical Home (PCMH) requirements and so on.

Examples of physician de-skilling were revealed in a recent study which consisted of in-depth interviews with 78 primary care physicians regarding EMR use.  EMRs are all about standardization – what data is captured and recorded, how data is reported, how data is used, and so on.

Over the course of the interviews, physicians in the study described significant examples of de-skilling behavior.  Most indicated  that Read more »

*This blog post was originally published at Mind The Gap*

New App Allows Patients To Directly E-mail Their Physicians

Group Health, a Seattle, Washington based nonprofit healthcare organization has launched a medical app for their members that offers a wide variety of features — even allowing members to directly e-mail their physicians.

This should come as no surprise to those who have been following this revered Health Co-op.  They have been featured by the NY Times, CNN, and other medical publications due to their innovative approach to patient care — such as embracing electronic medical records before everyone jumped on the bandwagon.

Some of the other interesting features this app will offer their patients: mobile access to medical records, which means a member can check their test results, making appointments, check immunization histories, view summaries of past visits, get routine care reminders and view their allergies and other  health conditions.

Additionally, Read more »

*This blog post was originally published at iMedicalApps*

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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