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A Truly Useful EMR

I love computers. Really, I do. Despite my oft-repeated claims about the shortcomings of electronic medical records in their current form, I do believe that information technology has the potential to be of great help to me and other physicians in providing quality care to Americans.

Stop laughing. I really mean it.

I do not believe, however, that IT best serves the medical needs of our patients when used to create non-interactive silos of information sequestered in the offices and clinics of individual doctors. Even hospitals and large integrated health systems information remains stuck within that system, providing limited utility when patients travel, or even go to a doctor not affiliated with the system.

Although some (especially in government) seem to feel that expanding those kinds of integrated systems is the way to go, the problem is that not all patients want to get their care from Mayo Clinic clones across the country. Still, I have an idea for using currently available technology to vastly improve the way medical care is delivered anywhere in this country. Read more »

*This blog post was originally published at Musings of a Dinosaur*

The Divide Between You And Your Medical Records

You have a right to your medical record. It’s true –- the record of every test and procedure you’ve had done, any films or studies, your doctors notes — it’s all yours if you ask for it. But it’s not that simple.

If you’re sick, your “record” is likely in pieces in lots of different places. Some of it is in paper files and computers in the offices of each of your doctors, or in the clinics where you had a test or procedure. It’s in multiple computer systems in a hospital, or in a folder in a radiology department, a container in a pathology department, or the computer system of a pharmacy. Each of these places has their own policy or procedure if you want your record. There are forms you have to fill out, fees you have to pay, time you have to wait.

So while you have a “right” to your records, for practical purposes, you’re going to have a very difficult time actually getting them. (By the way, this is something our team at Best Doctors does very well.) But let’s say you actually get all of your medical records. Now what? Read more »

*This blog post was originally published at See First Blog*

Why Improved Patient Care Isn’t “In The Chart”

Why do we physicians chart the way we do? Hopefully, we do it perfectly well and have no concerns at all. But where I practice emergency medicine, we are approaching maximum inefficiency in charting.

It all became much clearer when we started using our new EMR system. Let me make it clear, I’m not against EMR. In fact, typing and templates work better for me than dictating. My dictations were usually a mine field of blanks and misunderstood words.

Furthermore, if I wanted to use it, we have a new voice recognition dictation system in addition to our templated chart. Though admittedly, the voice recognition program clearly hates some of my partners, as evidenced by the way they grasp the screen and yell at it (‘Chest Pain, not west rain!’) and by its inexplicable use of profanity in the occasional chart.

But I digress. The problem as I see it is the evolution of the medical record. Why does the medical record exist? Read more »

*This blog post was originally published at*

Electronic Medical Records: What Is “Meaningful Use?”

Quiz:  What does the term “meaningful use” mean?

A.  Using something in a way that gives life purpose and leads to carefree days of glee.

B.  It depends on your definition of the word “term.”

C.  It’s not mean. It’s really nice.

D.  A large number of rules created by the government to assess a practice’s use of electronic medical records (EMRs) so that they can spur adoption, give criteria for incentive rewards, and have physicians in a place where care can be measured.

E.  Job security for those making money off of health IT.

The answer, of course, is D and E. Read more »

*This blog post was originally published at Musings of a Distractible Mind*

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

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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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