December 18th, 2011 by Dinah Miller, M.D. in Opinion, Research
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For a while now we’ve been talking about issues related to psychiatry and electronic medical records. Roy is very interested in the evolution of EHR’s.
I don’t like them. I think they have too many problems still, both in terms of issues of efficiency and time, and how they divert the physician’s attention away from the patient, and they focus medical appointments on the collection of data– data that is used in a checkbox form: patient is not suicidal and I asked, whether it was clinically relevant or not– and will therefore serve as protection in a lawsuit, or demographic information used by insurers, the government, who knows.
From a privacy standpoint, I think they are appalling. If you are a patient in the hospital where I work, you get Read more »
*This blog post was originally published at Shrink Rap*
December 11th, 2011 by Jessie Gruman, Ph.D. in Health Policy, Health Tips, Opinion
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Did you know that every nursing home resident in the U.S. must be asked every quarter whether she wants to go home, regardless of her health or mental status? And if she says yes, there is a local agency that must spring into action to make that happen.
This is the result of a 2010 Center for Medicaid/Medicare Services regulation aimed at helping keep older people in their (less expensive) homes rather than institutional settings. A New York Times article notes that the nursing home exodus, while modest to date, is building. This means the number of people with serious chronic conditions like congestive heart failure, diabetes and chronic obstructive pulmonary disease who draw heavily on community-based primary care services will grow.
These returnees are joining their peers and the blossoming crowd of us Baby Boomers who intend to resist living in nursing homes with as much spirit as our parents did, while the consequences of our plump and sedentary lifestyles arrange themselves into a constellation of diabetes, congestive heart failure and COPD similar to the one that plagues our elders.
Much has been written about Read more »
*This blog post was originally published at Prepared Patient Forum: What It Takes Blog*
December 9th, 2011 by Elaine Schattner, M.D. in Opinion, True Stories
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Over the weekend I developed another bout of diverticulitis. Did the usual: fluids, antibiotics, rest, avoided going to the ER, cancelled travel plans.
One of my doctors asked a very simple question: is this happening more frequently? The answer, we both knew, was yes. But I don’t have a Personal Health Record (PHR) that in principle, through a few clicks, would give a time-frame graph of the bouts and severity of the episodes over the past several years.
The last time this happened, and the time before that, I thought I’d finally start a PHR. Like most compulsive patients, I keep records about my health. In the folder in my closet in a cheap old-fashioned filing box, the kind with a handled top that flips open, I’ve got an EKG from 15 years ago, an Read more »
*This blog post was originally published at Medical Lessons*
December 4th, 2011 by DavedeBronkart in News, Research
1 Comment »
Wow. Todd Park, Chief Technical Officer at HHS, ought to be jumping out of his skin with joy at this one.
This time, House, M.D. fans, it was lupus. The article “Evidence-Based Medicine in the EMR Era” published in the Nov. 10 issue of the New England Journal of Medicine might have read like a House television script, but it was a real-life glimpse of what the most optimistic health IT advocates are hoping will become commonplace in U.S. health care: Mining EHR data to arrive at treatment decisions.
In a Health IT Exchange piece (on TechTarget) EHR data spurs real-time evidence-based medicine, Don Fluckinger summarizes (and dramatizes, accurately) this early specimen of care being transformed – beyond the literature – by looking at past records. Faced with a 13 year old lupus patient with a complex problem (see article for details)…
In four hours, they did a retrospective study of similar patients in the hospital’s data warehouse…, and decided to move ahead with the treatment based on the previous results of 98 [similar patients] … The authors said they will never know if they made the “correct” decision, but they did know that — in absence of randomized trial research to support their decision — they acted on the evidence of the best data available, coupled with their experience.
“Our case is but one example of a situation in which the existing literature is insufficient to guide the clinical care of a patient,” the authors wrote. …
What are we waiting for, people?? Imagine if Read more »
*This blog post was originally published at e-Patients.net*
November 14th, 2011 by Bryan Vartabedian, M.D. in Opinion
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I always loved to type. It started in high school with typing class. We were told that typing was critical for college term papers. I liked it so much that I took advanced typing. It was myself and 12 girls with Farrah Fawcett hair. Heaven.
Fast forward to 2011. My interface with the medical record is my fingers. Most of my communication flows through my hands. I complete the core of my documentation in the exam room. Fast documentation of information at the outset of an encounter allows for meaningful, eye-to-eye dialog during the latter part of the visit.
Those who can’t type have a different experience with their EHR. Sure there’s voice recognition but when pressed they wish they could make a sentence instantly flow onto the screen. Two colleagues this week, one from Barbados and another from the UK, Read more »
*This blog post was originally published at 33 Charts*
For a while now we’ve been talking about issues related to psychiatry and electronic medical records. Roy is very interested in the evolution of EHR’s.
