December 2nd, 2011 by Jessie Gruman, Ph.D. in Health Policy, Opinion
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Here’s the bad news: We will not benefit from the health care services, drugs, tests and procedures available to us unless we pay attention, learn about our choices, interact with our clinicians and follow through on the plans we make together. And that “following through”part? We have to work at doing that every day, whether we feel sick or well, energetic or tired out. And if we can’t do it, we’d best find a spouse or parent or friend or social service agency who can step in to do the things we can’t manage.
OK. For some people, this is not bad news. This is how we think it should be: “Nothing about me without me.” For others, our personal encounters with tests and treatments and illness have taught us that this is just the way it is.
But for many of us, this news – should we have reason to attend to it – is inconsistent with our idealized vision of health care that, tattered as its image might be, will step in, take over and fix what ails us. Most of us, after all, are mostly well most of the time and our exposure to health care is minimal.
Efforts to improve the effectiveness of health care and contain its cost have produced Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
November 6th, 2011 by Bryan Vartabedian, M.D. in Opinion
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I saw it begin to happen in the ’90′s. Residents came to rounds with their daily notes produced on a word processor. The notes were impressive. Legible, lengthy and meticulously detailed at first glance.
Then I started to notice a pattern. The impressive notes began to look very much alike. The thorough exam varied little from patient to patient. And problems that occurred on previous days seemed to persist in the medical record, even when it had resolved. In some cases the previous day’s note was printed only to have one or two additional elements added by hand. It was never really clear what was worse: the lack of effort or the illegible writing.
Our electronic health records (EHR) offer similar options. We can smart text our way to clinical efficiency. Some doctors have entire impressions and elements of the history pre-generated for common conditions. These are advertised features of the most common EHRs. Technology can make us look Read more »
*This blog post was originally published at 33 Charts*
November 1st, 2011 by RyanDuBosar in Research
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Physicians need at least three to five days of training on new electronic health record (EHR) systems to achieve the highest level of overall satisfaction, but nearly half of new users get three or fewer days of training, according to a survey.
AmericanEHR Partners surveyed physicians’ experiences with EHRs to achieve some meaningful use requirements. (The group is a web-based resource for EHR system selection/implementation developed by the American College of Physicians and Cientis Technologies).
AmericanEHR Partners used a 139-question online survey to collect data form physicians, nurse practitioners and physician assistants about their use and satisfaction with EHRs and health information technology. Survey data from more than 2,300 physicians in conjunction with five different professional societies was collected from April 2010 to July 2011. Results appeared at the group’s website.
There were Read more »
*This blog post was originally published at ACP Internist*
October 25th, 2011 by Happy Hospitalist in Health Policy, Opinion
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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*
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*
