The Last Zombie Conversion: A Final Look At Paper Medicine And Some Advice For EMR Vendors
In conclusion, it is obvious to me that we have a long way to go in making EMRs fit our natural pre-zombification hospital workflow. At the very least, we should be developing the following tools:
1. We need better ways to separate the signal from the noise. Even something as simple as a different font color for the new information that we doctors enter (in a given progress note) would help the eye latch on to what’s important. There should be a simple, visual way to distinguish between template and free text.
2. We need a pen feature that allows authors to signify emphasis. Wouldn’t it be nice if there could b...
Source: Better Health - March 10, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Data Digital Revolution Electronic Medical Records Systems EMR Hospitals How To Improve EMRs Order Entry Paper Medicine Recommendations Zombies Source Type: blogs
Cartoon: Hospital Charges Are Out Of Control
(Source: Better Health)
Source: Better Health - March 6, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny Hospitals Inpatient Costs Nasal Cannula Outrageous Oxygen Prices Run away costs Source Type: blogs
Why Patient Autonomy Is Critical To Good Health Care
Many of the patients that I treat have brain injuries. Whether caused by a stroke, car accident, fall, or drug overdose, their rehab course has taught me one thing: nobody likes to be forced to do things against their will. Even the most devastated brains seem to remain dimly aware of their loss of independence and buck against it. Sadly, the hospital environment is designed for staff convenience, not patient autonomy.
In the course of one of my recent days, I witnessed a few patient-staff exchanges that sent me a clear message. First was a young man with a severe brain injury who was admitted from an outside hospital. EMS...
Source: Better Health - February 24, 2015 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Atul Gawande Being Mortal Bibs Depression Goals of Health Care Nursing Homes Patient Autonomy Rehabilitation Source Type: blogs
Cartoon: How Some Surgeons Behave In The O.R.
(Source: Better Health)
Source: Better Health - February 13, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny cartoon General Surgery Music Nursing O.R. Surgeon Behavior Surgeons Source Type: blogs
Cartoon: Why A Patient’s Time May Be More Valuable Than Her Physician’s
(Source: Better Health)
Source: Better Health - February 6, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny Humor cartoon Geriatrics Medicine Seniors Tardiness Tardy Physicians Time Is Valuable Wait Times Waiting Room Source Type: blogs
Documenting To Death: Are EMRs Eroding The Soul Of Medicine?
Electronic medical record systems (EMRs) have become a part of the work flow for more than half of all physicians in the U.S. and incentives are in place to bring that number up to 100% as soon as possible. Some hail this as a giant leap forward for healthcare, and in theory that is true. Unfortunately, EMRs have not yet achieved their potential in practice – as I have discussed in my recent blog posts about “how an EMR gave my patient syphillis,” in the provocative “EMRs are ground zero for the deterioration of patient care,” and in my explanation of how hospital pharmacists are often the las...
Source: Better Health - February 2, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Billing CMS Coding Documentation EHR Electronic Medical Records EMR Health Insurers Healthcare Quality Medical Errors Patient Care Pros And Cons Source Type: blogs
Cartoon: Electronic Medical Errors May Be Impossible To Erase
(Source: Better Health)
Source: Better Health - January 30, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny cartoon EMR Medical Error Suggestions For Fixing Errors Source Type: blogs
Why Would Any Doctor Accept Medicaid?
A physician friend of mine posted a copy of her Medicaid reimbursement on Facebook. Take a look at the charges compared to the actual reimbursement. She is paid between $6.82 and $17.54 for an hour of her time (i.e. on average, she makes less than minimum wage when treating a patient on Medicaid).
The enthusiasm about expanding Medicaid coverage to the previously uninsured seems misplaced. Improved “access” to the healthcare system via Medicaid programs surely cannot result in lasting coverage. In-network physicians will continue to dwindle as their office overhead exceeds meager reimbursement levels.
In realit...
Source: Better Health - January 26, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion ACA Health Insurance medicaid Minimum Wage Obamacare Physician Reimbursement Untenable Widening The Gap Source Type: blogs
Cartoon: Why Some Doctors Love EMRs
(Source: Better Health)
Source: Better Health - January 23, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny Benefits cartoon Copying Notes EMR Plagiarism Source Type: blogs
Credibility & Prestige In Medicine: How Are They Measured?
In my last blog post I discussed how harmful physician “thought leaders” can be when they are dismissive of the value of other specialists’ care. I must have touched a nerve, because a passionate discussion followed in the comments section. It seems that physicians (who spend most of their time involved in clinical work) are growing tired of the leadership decisions of those who engage in little to no patient care. Clinicians urge lawmakers to turn to practicing physicians for counsel, because those who are out of touch with patients lack real credibility as advisers.
Interestingly, the credibility questi...
Source: Better Health - January 21, 2015 Category: American Health Authors: Dr. Val Jones Tags: Opinion True Stories Academia Credentials Credibility healthcare KOLs Medicine Physicians Prejudice Prestige Thought Leaders Town Versus Gown Source Type: blogs
If Emergency Medicine Physicians Told Hospitalists The Truth…
(Source: Better Health)
Source: Better Health - January 16, 2015 Category: American Health Authors: Dr. Val Jones Tags: Friday Funny cartoon Diagnosis Emergency Medicine Hospitalists Original Truth Val Jones Source Type: blogs
Physician Specialty Silos Can Cause Friendly Fire Casualties
It’s no secret that medicine has become a highly specialized business. While generalists used to be in charge of most patient care 50 years ago, we have now splintered into extraordinarily granular specialties. Each organ system has its own specialty (e.g. gastroenterology, cardiology), and now parts of systems have their own experts (hepatologists, cardiac electrophysiologists) Even ophthalmologists have subspecialized into groups based on the part of the eye that they treat (retina specialists, neuro-ophthalmologists)!
This all comes as a response to the exponential increase in information and technology, making ...
Source: Better Health - January 13, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Policy Opinion Cardiology CMS Eric Topol Inpatient Rehabilitation NPR Patient Care Silos Smartphones Technology Thought Leaders Source Type: blogs
Knee Arthritis Treatments Ranked By Relative Effectiveness
In conclusion, the elephant in the room is that weight loss and exercise are still the very best treatments for knee osteoarthritis. Check out the American Academy of Orthopedic Surgery’s recent list of evidence-based recommendations for the treatment of knee arthritis for more information about the full spectrum of treatment options. (Source: Better Health)
Source: Better Health - January 5, 2015 Category: American Health Authors: Dr. Val Jones Tags: Health Tips Research Acetaminophen Annals Of Internal Medicine Celecoxib Comparative Effectiveness Corticosteroids Diclofenac hyaluronic acid Ibuprofen Knee OA Osteoarthritis What Works For Knee Pain? Source Type: blogs
How To Be A Successful Patient: Young Doctors Offer Some Advice
I am proud to be a part of the American Resident Project, an initiative that promotes the writing of medical students, residents, and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to help patients take control of their health. Dr. Marissa Camilon (MC) is an emergency medicine resident at LA County USC Medical Center, Dr. Craig Chen (CC) is an anesthesiology resident at Stanford Hospitals and Clinics, and Dr. Elaine Khoong (EK) is a resident in internal medicine at San Francisco General Hospital. Here&...
Source: Better Health - December 12, 2014 Category: American Health Authors: Dr. Val Jones Tags: Expert Interviews Health Tips Apps Empowered Patients EMR Health Outcomes Mobile Health Poverty Texting The American Resident Project Source Type: blogs
Why Don’t Doctors Round With Nurses Anymore?
Whenever possible I make a point of rounding on patients with their nurses present. I rely on nurses to be my eyes and ears when I’m not at the bedside. I need their input to confirm patient self-reports of everything from bowel and bladder habits to pain control, not to mention catching early warning signs of infection, mental status changes, or lapses in safety awareness. Oftentimes patients struggle to recall bathroom details, and they can inadvertently downplay pain control needs if they don’t happen to be in pain when I visit them. A quick check with their nurse can clarify (for example) that they are aski...
Source: Better Health - December 1, 2014 Category: American Health Authors: Dr. Val Jones Tags: Health Tips Opinion Change Of Shift Medical Errors Medical Rounds With Nurses Physician Communication Signout Team Rounds Source Type: blogs
