March 07, 2013
Electronic Health Records
When I was at Iowa about 10 years ago, I couldn't believe the medical records system. Every patient had a spiral-bound gold folder, and undergrads would push metal carts piled high with them around the hospital. It seemed so silly that I could access any academic journal article I wanted from any computer at the University (or even at home!) but doctors had to wait wobbly wheely carts to make way through halls and elevators.
And it was silly. Time was being wasted, mistakes were being made, information was no doubt lost (I have no evidence it was). So people are working to make these things work better. But change always brings pushback, and change always brings unexpected complications and inefficiencies. And the conservative folk who opposed the change always have a valid argument that it was a bad idea, even if the change is mostly for the better.
This last year I've watched Michigan adopt a new electronic records system called MiChart, and I've heard nothing but grumbles. I watched our own family physician, talking smooth doc-talk to my wife's complaint of a sore throat, slowly turn to a mumbling grump because he couldn't find the right pull-down menu on the user interface to just order the damn strep test.
I assume as people grow into a EHR system, they with bristle. Every new software is confusing and ugly and irritating. And certainly the federal government's push to get everyone on compatible EHR systems makes it feel worse.
What I can't assume is that EHRs will prove better than pushing carts of paper around. But they have to, right? Mayo's been doing EHRs for a while now, and managing good records is pretty much what made them famous: efficient information facilitates good care.
Anyhow, I found this article in my news feed and it got me thinking about this again. Students are being trained in an EHR setting and will no doubt be more comfortable with this stuff than my paper-head family physician will ever be.
October 23, 2012
I believe the children are our future
Targeted, evidence-based public health advocacy from M4s using multimedia published for free online. Not bad, St. Louis!
October 10, 2012
Dr. Social Media
There's a New York Times article that was published a few days ago called Redefining Medicine with Apps and iPads and I can't bring myself to read it. The ugliness of the title is too much for me. "Redefining" medicine? What does that mean? "Apps"? You mean a trendy new fake-word for computer programs? "iPads"? You mean a registered trademark for a type of portable computer? Is this an advertisement? When I first got into the medical education game, everyone was convinced the PDA (remember that term?) would change medicine. Now it's "Apps and iPads?" Nope.
Doctors still carry pagers. Chew on that one for a bit.
But even so I'm pretty sure social media is going to be a big deal in medicine. It probably won't change anything about the clinical examination or treatments, but it definitely will change patient-physician interactions. But it will only have an effect if institutions allow doctors to use it. Patients really want doctors to use it. Doctors (at least those below a certain age and of a certain disposition) are eager to use it. But institutions have things like "legal departments" and are wary of things like "ethics violations" so there is resistance.
All this to say that this is a very good thing.
August 10, 2012
Another new treatment
It's a constant, battery-powered, RF computer-controlled drip of baclofen for people with muscle control problems: palsy, MS, etc. If the delivery system isn't too buggy, I assume this could become standard for all sorts of chronic, drug controlled disorders. I'm lookin' at you, Diabetes.