September 27th, 2011 by StevenWilkinsMPH in Research
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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*
September 23rd, 2011 by Lucy Hornstein, M.D. in True Stories
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Got a call from a long-time patient over the weekend. Hearing a not overly alarming story but one that was not terribly reassuring either, I suggested she go to the Emergency Department.
Later that morning, sitting at an internet cafe with DSS eating breakfast, each of us surfing on our respective laptops, he says conversationally, “So I see Miss LTP is in the ER.”
My heart stopped and my stomach dropped. Had he managed to access the voicemail program I use for after hours calls? My EMR? Had I left shortcuts up to any patient-related materials on that machine? When had I last used it anyway? My mind was racing. I wasn’t all that concerned specifically about him knowing that a particular person was in the ER, since he understands confidentiality. But if he was able to access confidential patient information, did that mean I had a security breach?
“How do you know that?” I asked him carefully, after a very long pause, during which all of the above ran through my head. Read more »
*This blog post was originally published at Musings of a Dinosaur*
September 15th, 2011 by Davis Liu, M.D. in News, Opinion
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One of my favorite movies is Back to the Future starring Michael J. Fox. I must admit after reading this New York Times piece, titled “When Computers Come Between Doctors and Patients” I have to wonder.
Am I fortunate to be coming from the future? Because I completely disagree with Dr. Danielle Ofri, again.
I’ve had the privilege and opportunity to work in a medical group which has deployed the world’s largest civilian electronic medical record and have been using it since the spring of 2006. I don’t see the issue quite as much as Dr. Ofri did. It is possible that she examined patients in her office with a desk rather than an examination room.
If placed and mounted correctly in the exam room, the computer actually is an asset and can improve the doctor patient relationship. It is part of the office visit. The flat screen monitor can be rotated to begin a meaningful dialogue between the patient and me. Read more »
*This blog post was originally published at Saving Money and Surviving the Healthcare Crisis*
September 13th, 2011 by Iltifat Husain, M.D. in News
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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*
September 11th, 2011 by DavedeBronkart in News
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Big news from Down Under: the Sydney Morning Herald reports that a group of fifty consumer health advocates has unanimously backed an “opt-out” process for enrollment in electronic health records, reversing their previous position.
The issue is whether by default all patients have an EHR. “Opt-out” means you’re in by default – your records will be stored electronically – and you can opt out if you want. “Opt-in” means you do not have an EHR unless you specifically ask for one.
The group, the Consumer Health Forum, cites evidence from the neighboring country of New Zealand, in which Read more »
*This blog post was originally published at e-Patients.net*
