EHR

The Impending Revolution

Like my practice, membership medicine is still in its early phases.  Like my practice, the future of membership medicine depends on a lot of things beyond our control.  But the excitement I hear regularly from physicians, residents, medical students, patients, business owners, and even politicians about its potential is quite remarkable.  Both of these conferences were full of something that I once thought no longer existed: doctors who were excited about medicine and cautiously optimistic about the future.

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The Pain and Inflammation of Documentation

My previous two posts lamented the incredibly bad the documentation I get from a local hospital is.  In truth, the documentation I get from everyone is terrible.  Seldom does it tell me what I actually want to know, and if there is useful information it is buried in an avalanche of yada yada.  The main reason for this is that documentation is driven by our ridiculous payment system, which requires us to follow arcane rules to generate notes that justify the obscure codes we submit for money from the payors.  This is the reason for much of the gibberish.  These rules, combined with computers\’ ability to quickly and efficiently generate drivel (see also The Entire Internet) are the hot house and Miracle Gro for meaningless words.  Sprinkle the rules on a computerized medical record and stand back!  Useless words and codes will spew out at you like milk from the mouth of an overfed baby.

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Computerized Epic Failure

Good news: my local hospital has the fanciest, newest, coolest computer system (costing major bucks, of course) and now is routinely sending me \”transition of care\” documents on my patients.

Bad news: they are horrible.

Seriously, we get several of these documents per day and often can\’t figure out what the document is about.  On the bright side, sometimes after taking 10-20 minutes of looking through the 12-14 page document, we do actually gain some useful information.

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Personal Tech

When I say we need more tech, I am not saying we need more computerization so we can produce a higher volume of medically irrelevant word garbage.  I am not saying we need to gather more points of data that can measure physicians and \”reward\” them if they input data well enough.  The tech I am referring to is like that I used regarding my father.  I want technology that does two things: connects and organizes.  I want to be able to coordinate care with specialists and to reach out to my patients.  I want my patients to be able to reach me when they need my help.  Technology can do this; it sure did for my dad.

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