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*
October 25th, 2011 by Bryan Vartabedian, M.D. in Opinion
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While most of us fail to see it, doctors are changing. We’re changing as a result of the social and technological innovation. In 2050 what we do and how we do it will be very different from what we did at the turn of the century. We’re evolving from analog to digital. I think it’s important to consider the ‘digital physician’ as a concept worthy of attention. The training and support of this emerging prototype has to meet its different needs and workflows. Perhaps the criteria by which we choose medical students should take into consideration the anticipated skill sets and demands of this next generation. And we need hard information about the digital physician and her habits.
Here are some differences between the digital and analog physician:
The digital physician
- Information consumption is web-based
- Rarely uses a pen. Care and correspondence is conducted through an EMR.
- Socially connected. Comfortable with real time dialog at least on a peer-to-peer level. Recognizes Read more »
*This blog post was originally published at 33 Charts*
August 15th, 2011 by Lucy Hornstein, M.D. in Opinion
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Seven months into 2011, things look very different than they did this time last year at my office. Not only have I been using an electronic medical record for nine months now, but I’ve also been submitting claims electronically (through a free clearinghouse) using an online practice management system. I’ve also begun scanning patients’ insurance cards into the computer, as well as converting all the paper insurance Explanation of Benefits (EOBs) into digital form. I’ve even scanned all my office bills and business paperwork and tossed all the actual paper into one big box. As of the first of the year I even stopped generating “daysheets” at the end of work each day. After all, with my new system I can always call up the information I want whenever I need it.
How did such a committed papyrophile get to this point? It is the culmination of a process that actually began last summer with the purchase of an adorable refurbished little desktop scanner from Woot ($79.99, retails for $199, such a deal!) The organizational software is useless for my purposes, but it does generate OCR PDFs, which makes copying and pasting ID numbers from insurance cards into wherever else they need to be a piece of proverbial cake. The first step was to start Read more »
*This blog post was originally published at Musings of a Dinosaur*
July 23rd, 2011 by Peggy Polaneczky, M.D. in Opinion
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My practice has been using the EPIC electronic medical record for 5 years now, and it’s taken about that long for me to figure out how to tweak the system to make myself more efficient, and for the system to evolve to a place where I could tweak it myself.
Case in point – Quick Actions.
EPIC’s most recent upgrade includes little self-made macros called “quick actions” that turn repetitive tasks into a mouse click. I’m using quick actions to manage my results in basket in much the same way you may be using Rules in Outlook to manage your email.
Some of my macros are actually little work-arounds for a system that is not yet entirely integrated and a patient population that has not yet embraced online results communication. About half of my patients sign up for online results – I’m working hard on the rest…
Like many of you, I like a clean inbox, but need a place to park messages that are awaiting some future task for completion. I’ve decided to use the “results notes” inbasket for this purpose, so you’ll see some of my macros moving messages there.
I now have the following Quick Action options whenever I view a lab report – Read more »
*This blog post was originally published at The Blog That Ate Manhattan*
December 7th, 2010 by Bryan Vartabedian, M.D. in Better Health Network, Opinion
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We all want technology to improve communication between doctors and patients. We fantasize that social tools will open doors and bridge the expanding divide between doctors and patients.
I’m wondering if it’s a case of unicorns and rainbows: Fancy new tools to do the old thing in a less-effective way. I’m guessing that if Facebook was the old platform for doctor-patient dialog and the telephone was invented this year, everyone would be clamoring to use the phone (“Dude, this is amazing…you can hear them talk.”)
I like the telephone. Written copy misses intonation, timing, pitch, and all the other rich elements of human speech. Subtle changes in a parent’s voice tell me if I’ve made my point and exactly how I need to proceed [with caring for their child]. Unspoken words on a screen are so one-dimensional.
Of course, email has a tightly-defined place in patient communication. And real-time social interaction between patient and clinic will evolve to have a clear role in patient care. But for now, the phone remains one of the most effective tools for helping doctor and patient really understand one another.
[Image credit: Cemagraphics]
*This blog post was originally published at 33 Charts*
