October 12th, 2010 by KevinMD in Better Health Network, Health Policy, News, Opinion, Research
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One of the supposed strengths of electronic medical records is better tracking of test data. In theory, when using more sophisticated digital systems, doctors can better follow the mountains of test results that they encounter daily.
But a recent study, as written in the WSJ Health Blog, says otherwise. Apparently, a study performed in 2007 found:
VA doctors failed to acknowledge receipt of 368 electronically transmitted alerts about abnormal imaging tests, or one third of the total, during the study period. In 4% of the cases, imaging-test results hadn’t been followed up on four weeks after the test was done. Another study, published in March in the American Journal of Medicine, showed only 10.2% of abnormal lab test results were unacknowledged, but timely follow-up was lacking in 6.8% of cases.
Consider that the VA has what is considered the pinnacle of electronic systems — their unified, VistA program that permeates all their hospitals and clinics. Apparently the problem is one of alert overload:
Hardeep Singh, chief of the health policy and quality program at the Houston VA’s health and policy research center, led both studies. He tells the Health Blog that doctors now receive so many electronic alerts and reminders — as many as 50 each day — that the important ones can get lost in the shuffle.
This is not unlike the alarm fatigue issue that I recently wrote about. Too much data — whether it is written or on the screen — can overwhelm physicians and potentially place patients at harm. Curating test results by prioritizing abnormals will really be the true power of electronic test reporting.
*This blog post was originally published at KevinMD.com*
September 22nd, 2010 by AlanDappenMD in Better Health Network, Health Policy, Opinion, Primary Care Wednesdays, True Stories
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My desire for integrating the power of technology with primary care started nearly two decades ago. It was then, when working as a family physician in a busy medical practice, that I began experimenting with typing my notes and using computers in front of my patients.
In 2001, I launched a new medical practice DocTalker, focusing on access of medical care to patients, and almost immediately I started searching in earnest for an EMR solution to fit my needs. However, I was not happy with the systems I looked into and tested and felt that they didn’t do what I needed them to.
Some of my discontent came from the way my medical practice consults with patients, which is primarily via telephones and emails and house calls (in addition to the common office visit). Because of our ability to offer telemedicine, we often treat patients when they’re not in town, but rather traveling for business or taking a vacation. We therefore must interface with hundreds of different local labs, radiology groups, pharmacies, and specialists. Read more »
August 25th, 2010 by Lucy Hornstein, M.D. in Better Health Network, Health Policy, Opinion
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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*
August 2nd, 2010 by RyanDuBosar in Better Health Network, Health Policy, Health Tips, News, Research
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Monitoring vital signs remotely saves time and money for everyone: patients, physicians, facilities and insurers. Heart failure is a particular target because its increasingly common, its easily triggered (by as little as too much salt on food, for example), it costs so much to manage in the hospital, and it’s so easily avoided.
Remote monitoring equipment made even easier with wireless connections can take vital signs, and even ask standard questions every morning. The equipment puts patients in contact with nurses once they detect warning signs. That human touch is key. Case managers can screen out false alarms (avoiding alert fatigue) and can direct patients to the physician when needed. ACP Internist covered remote monitoring technology in its March issue. (Wall Street Journal, ACP Internist) Read more »
*This blog post was originally published at ACP Internist*
July 2nd, 2010 by DrRob in Better Health Network, Humor, Opinion, True Stories
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It’s been a very long time since I did an “Ask Dr. Rob” post. It’s also been a long time since I shot a spitball out of a straw and hit someone behind the ear during social studies class. I realize that just because it’s been a long time since I’ve done something, it doesn’t mean the world is better off with me doing it again.
Still, there have been some interesting questions that have come up and I think it’s time they should be answered. They’re both along the same line:
Question 1: What’s the difference between health care and healthcare? I see that you contribute to the Health Care Blog, but you write about healthcare all of the time. What’s the deal?
Question 2: What’s the difference between EMR and EHR? It seems that some people feel that it’s vile and uncouth to call it “EMR,” only accepting people who call it “EHR” into their secret societies of people who are smarter than everyone else. What’s the deal? Read more »
*This blog post was originally published at Musings of a Distractible Mind*
