Dr. Lisa Rosenbaum has an excellent piece in the NEJM this week entitled Transitional Chaos or Enduring Harm? The EHR and the Disruption of Medicine. In essence a review of Dr. Robert Wachter’s book The Digital Doctor: Hope, Hype, and Harm at the Dawn of Medicine’s Computer Age, it deals with the ever increasing intrusion of… Continue reading Reining in the EHR Monster
Category: Computers & Software
Prank Calling Kurt Gödel
Prank calling used to be a common, albeit annoying, form of entertainment back in the days when I grew up, before the invention of caller ID ruined it forever. Some prank calls were just simple and stupid jokes, such as the “do you have Prince Albert in a can?” call. On a slightly more elevated level… Continue reading Prank Calling Kurt Gödel
Why Electronic Health Records Will Not Get Better
Today I read an article in Politico entitled “Doctors barred from discussing safety glitches in U.S.-funded software.” The article states that, despite massive public funding of Electronic Health Records (EHR), the EHR corporations (including Epic Systems, Cerner, Siemens, Allscripts, eClinicalWorks and Meditech) routinely attach gag clauses to contracts with the hospitals and medical groups who… Continue reading Why Electronic Health Records Will Not Get Better
You Can’t Tell the Batters Without a Scorecard
If you want to know who the best surgeon in the hospital is, ask the surgical nursing staff. If you want to know who does the best job opening up coronary arteries using catheters, balloons, and stents, ask the cardiac catheterization lab nurses and technicians. Unfortunately these approaches to comparing physicians’ skills are only available to hospital… Continue reading You Can’t Tell the Batters Without a Scorecard
What If My CHA2DS2-VASc Score Is One?
There is nothing simple about atrial fibrillation; it is a complicated, often overwhelming disease, both for patient and physician. One question that invariably comes up early on is the question of prophylactic anticoagulation for prevention of stroke. Who should receive anticoagulation? Which anticoagulant? How should anticoagulation be handled around the time of surgical procedures, or… Continue reading What If My CHA2DS2-VASc Score Is One?
Reading About Steve Jobs
I am interested in the history of computer technology and over the last couple months have read a lot about Steve Jobs. To be specific I read Walter Isaacson’s Steve Jobs, Brent Schlender’s Becoming Steve Jobs, and a book published back in 2001, Alan Deutschman’s The Second Coming of Steve Jobs. To get the point of… Continue reading Reading About Steve Jobs
Introducing EP Calipers
Ever since the 1990s, when computer-based electrophysiology (EP) systems were introduced, HV intervals and ventricular tachycardia cycle lengths have been measured in the EP lab by electronic calipers — simple but accurate measurements accomplished on-screen using a track ball or a mouse. Despite this, physicians still often carry a physical pair of calipers, perhaps preserved… Continue reading Introducing EP Calipers
EP Mobile Update Version 3.6 for Apple Devices
The reviewers at the Apple iTunes App Store have approved the revised version of the EP Mobile app. For information on why the app needed to be revised, see my earlier posts on the subject. I removed the drug dose calculators (note though that the Warfarin Clinic module was not removed), but added detailed drug… Continue reading EP Mobile Update Version 3.6 for Apple Devices
Update on EP Mobile and Apple #2
As some of you are aware, the Apple App Store rejected an update to the EP Mobile app based on the presence of drug dose calculators in the app. The App Store guidelines state: 22.9 – Apps that calculate medicinal dosages must be submitted by the manufacturer of those medications or recognized institutions such as… Continue reading Update on EP Mobile and Apple #2
How to Build a Better Electronic Health Record Part 27 — Modularity
Editors note: This 27th entry in our web series on EHR design is excerpted from Electronic Health Record Software: Principles and Practices, 3rd Edition, by Paul Lockhart and Janet Twombley-Chu, published by Addison Wesley, June 2089. 3378 pages. ISBN: 103-978-1-4919-0498-5. Reprinted by permission. Amazon listing [1]. Chapter 7 EHR Modularity 7.1 A History Lesson In… Continue reading How to Build a Better Electronic Health Record Part 27 — Modularity