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Five Things That Electronic Medical Records (EMRs) Can Learn From Social Media

As a physician who openly despises many aspects of current EMRs (see “How An EMR Gave My Patient Syphilis” or “The Medical Chart: Ground Zero For The Deterioration Of Patient Care” ) I recognize that they are here to stay. And so, since we’re all stuck with these digital middlemen, I have some suggestions (based on popular social media platform functionality) for making them better.

1. Likes. Healthcare providers should be able to “vote up” an excellent note in the medical record. Let’s face it, not all doctors are equally good at documentation. Untold hours of our time are spent trying to cull through pages of auto-populated, drop-down-box checks to figure out what’s actually going on with a patient on a particular day. Once in a while you stumble upon some comprehensive free text that a physician took the time to type after a previous encounter, and suddenly everything becomes clear. If there were a way to flag or “like” such documents, it would help other readers orient themselves more quickly to a patient’s history. A “liking” system is desperately needed in EMRs and would be a valuable time saver, as well as encouragement to physicians who document notes well. Hospitals could reward their best note makers with public recognition or small monetary bonuses.

2. #Hashtags. Tagging systems are sorely lacking in medical records systems, which makes them very difficult to search. Patients make multiple visits for various complaints, often with numerous providers involved. If physicians had the ability to review notes/records unique to the complaint that they are addressing, it would save a lot of time. Notes could be tagged with keywords selected by the author and permanently recorded in the EMR. This would substantially improve future search efforts. Even if the EMR generated 10 search terms (based on the note) and then asked the physician to choose the 3 most relevant to the current encounter, that would be a step in the right direction.

3. Selfies. Medical records would benefit from patient-identifier photographs. In a busy day where 20-30 patients are treated and EMR notes are updated after the patients have gone home, a small patient photograph that appears on each documentation page will serve the physician well in keeping details straight. Patients should be able to upload their favorite portrait to the EMR if the standard one (perhaps taken during the intake process) is not acceptable to them. In my experience, nothing brings back physical exam and history details better than a photograph of the patient.

4. Contextual links. All EMRs should provide links to the latest medical literature (on subjects specifically related to the patient’s current diseases and conditions) in a module on the progress note page. and other reference guides could easily supply the right content (perhaps based on diagnosis codes). This will help physicians practice evidence-based medicine and keep current with changes in recommended treatment practices.

5. Microblogging. Sometimes there are important “notes to self” that a physician would like to make but don’t need to be part of the official medical record. EMRs should provide a free-text module (like a digital sticky note) for such purposes. These sticky notes should not be admissible in court as part of the medical record, and should not be uploaded to the cloud. Content included in these notes could include social information (patient’s daughter just had a healthy baby girl), hunches (patient looks slightly pale today – will check H&H next time if no change), and preliminary information (remember to review radiology result before calling patient next Tues).

It is my hope that EMRs will slowly adopt some best practices from top social media platforms. After all, if millions of users are effectively using voting, tagging, linking, searching and imaging in their daily online lives, it only makes sense to capitalize on these behaviors within the constraints of the medical environment. Maintaining strict confidentiality and appropriate professional boundaries (often missing in the social media world at large) is certainly possible with EMRs. Let’s build a better information capture and retrieval process for the sake of our patients, and our sanity.


At least one EMR is already providing #3 and #5 as part of its software: see Are you aware of any others already implementing these ideas?

Healthcare Blogging: Web Traffic And Trends

An interesting blog article from the folks at Compete came to my attention recently. Compete for those who don’t know is a fantastic analytics site to see how ANY website is doing in terms of popularity (number of visitors in a given time period). The basic data is free. For more in depth information, there’s a charge.

For example, for our practice’s website, here is the Compete data I pulled which is pretty accurate based on my own analytics information:

My nearest local competitor in terms of website popularity is the hospital, Fauquier Health System: Read more »

*This blog post was originally published at Fauquier ENT Blog*

How To Take Back Control Of Your Google Searches

Eli Pariser talks at TED about how we’re losing the internet to algorithmic gatekeepers at Google, Yahoo, Facebook and even our news sites, which tailor search results to what they think we want to see. Which is why I often start exploring my search results on page 10 instead of page 1. But what if some search results don’t even make it onto my queue?

The side by side comparison of two different users’ internet search on the term “Egypt” during the crisis there is a stunning example of how computerized gatekeepers choose for us what we see (and don’t see) when we log on.

You can’t have a functioning democracy if citizens don’t have a free flow of information.

I encourage you to watch the entire video, and hope the big mahoffs of the internet sitting in the TED audience heard Pariser when he told them this  - Read more »

*This blog post was originally published at The Blog That Ate Manhattan*

NLM Launches Mobile-Friendly PubMed Search App

Recently, we reviewed six medical apps for the iPhone and iPad that promised mobile PubMed searches — an essential functionality since the website is extremely difficult to view on a smart phone. As of last week, this is no longer the case. The U.S. National Library of Medicine (NLM) just launched a mobile friendly version of last week.

The Web App they have created is currently in beta, and as of this publish date, if you go to on your smart phone’s browser you will still be directed to the original non-mobile friendly website. However, if you point your phone’s browser to the following URL,, you are presented with the mobile version of the site.

The National Library of Medicine states the significant increase in mobile browsing for medical content is one of the key reasons they released this mobile web app. The folks at the NLM already have a plethora of mobile medical web apps available, such as the recently added MedLine Plus.

Continue on to see pictures of the PubMed app in action. Read more »

*This blog post was originally published at iMedicalApps*

Google Suggest: Why Only Negative Adjectives For Doctors?

The Efficient MD’s eyes are opened by the nasty thoughts Google Suggest offers up when someone starts typing “Doctors are…” Since Google Suggest lists only common results with which to complete your queries, it seems that the most common thing people think about doctors online is that we’re “overpaid” or “jerks” or “dangerous” or, most commonly, “sadists who like to play god.”

Surveys show people consider doctors to be among the most respected professions. So what gives? Read more »

*This blog post was originally published at Blogborygmi*

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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