#SAEM14 panel discussions on social media scholarship & clinical decision support
< div style= " cursor: pointer; " > < span style= " background-color: rgba(255, 255, 255, 0); " > I was very pleased this year to participate on two panels at SAEM in Dallas. & nbsp; < /span > < /div > < div style= " cursor: pointer; " > < span style= " background-color: rgba(255, 255, 255, 0); " > < br / > < /span > < /div > < div style= " cursor: pointer; " > < span style= " background-color: rgba(255, 255, 255, 0); " > On Thursday, I joined Michelle Lin and (remotely) Rob Cooney for the panel led by Jason Nomura, called " From Twitter to Tenure - Use of Social Media to Advance Your Academic Career " (search for DS067 i...
Source: Blogborygmi - May 16, 2014 Category: Emergency Medicine Authors: Nick Genes Source Type: blogs
Counting clicks
This month, EPMonthly ran an article about the cost of poorly-designed EHR on ED operations. The EPMonthly authors - Augustine and Holstein - ask some good questions and made some good points. But the data they used to ground their piece came from a peer-reviewed article that unfortunately leaves a lot to be desired.We ran an editor's note at the end of the EPMonthly piece, succinctly stating my objections to the original peer-reviewed research. But since this "4000 clicks" study has gotten traction elsewhere, I felt compelled to make my detailed criticisms of the article publicly available:The authors of the "4000 clicks"...
Source: Blogborygmi - February 1, 2014 Category: Emergency Medicine Authors: Nick Genes Source Type: blogs
NYEMHPA Future of EHR / Future of EM presentation
I'm honored to be presenting this afternoon at the New York Emergency Medicine Health Policy Assembly, organized by the Emergency Department at North Shore - LIJ.My prezi is available, as are my references. I'm told an audio file might become available as well.Follow tweets from the conference with #NYEMHPA - and keep your fingers crossed that a Storify recap appears at +David Marcus' conference site. (Source: Blogborygmi)
Source: Blogborygmi - December 11, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Medical apps to facilitate EM clinical exam and decision-making
This Monday at ACEP's Scientific Assembly I'm presenting at the Learning Lounge on the topic of smartphone apps for physical exam and on-shift clinical decision-making. I'll be joined on Tuesday and Wednesday by Jason Wagner and Harvey Castro, respectively. You can download the ACEP13 app for more details; my abridged list of recommended apps for Emergency Medicine is also available via Dropbox. One's choice of medical smartphone apps is of course quite subjective, borne as much out of habit and circumstance as some standard of quality. I'd be really interested to hear other suggestions or comments about this lis...
Source: Blogborygmi - October 13, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
CDM talk on updates in the diagnosis and management of ED arthritis
Welcome, readers from Clinical Decision Making. You've got a PowerPoint version of my talk on your USB drives; here's the link to today's Prezi.I frequently mentioned Chris Carpenter's excellent 2011 systematic review of ED septic arthritis; Margaretten's Systematic Review for JAMA is also worth a look.Other references from my talk:EPMonthly and EMPractice (new Rosen's chapter is not yet published)Terkeltaub's trial that changed colchicine regimens for goutKesselheim and Solomon in NEJM 2010 on the Curious Case of ColchicinePiper on the risks of local anesthetics on cartilageFitch 2008 on IA l...
Source: Blogborygmi - June 21, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Time on Task
There's a research paper making the rounds in the press and on social media, about Facebook usage in an emergency department.It's called, "Online Social Network Use by Health Care Providers in a High Traffic Patient Care Environment" by Erik Black et al, and it's in JMIR, a popular informatics journal that I thought had a reputation for quality. I say this, because the methods were poorly described and the conclusions are grossly misleading.Health policy wonks like Sarah Kliff made the following conclusion:For every hour emergency department workers use a computer, they spend an average of 12 minutes on Facebook — a...
Source: Blogborygmi - May 30, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
The politics of EHR implementation
I've pretty much kept my distance from the right-wing noise machine. They don't often talk about my professional interests, and when they do, it's not usually cited by a colleague or fellow academic.But this morning, someone I respect shared this screed from Michelle Malkin on the great EDBA listserv - which I'd always equated with intelligent discussion of applied emergency medicine informatics.So, let's dive into Malkin's piece on "Obama's crony," the CEO of Epic Systems:The stimulus law provided a whopping $19 billion in “incentives” (read: subsidies) to force hospitals and medical professio...
Source: Blogborygmi - May 24, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Another new day
While I've been focusing on peer-reviewed writing these days (though what could be more peer-reviewed than a blog?) you can see some of my thoughts on medicine & technology at ZocDoc's new site, The Doctor Blog.Browse their site - you'll see some familiar faces from the Grand Rounds era.Great content, too. (Source: Blogborygmi)
Source: Blogborygmi - March 31, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Enigma variations
We hear it all the time: one of the benefits of EHR will be to get a handle on physician practice variation. Between states, and even within departments, we diagnose and treat the same things very differently. By switching from paper to electronic charting, analysis of practice variation becomes a lot easier (it also becomes easier to steer physicians into following guidelines).With all this focus on how doctors do things differently, I'd like to turn the focus, however briefly, on the practice variability of government.Specifically, why is the physician's license fee so variable, from state to state? Little Rhode Island a...
Source: Blogborygmi - January 11, 2013 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Tincture of time
No one chooses emergency medicine for continuity of care. It's undoubtedly rewarding for most doctors to help manage patients through growth or disease, but the emergency physician doesn't get the chance to appreciate a patient's development over time.Until now.Electronic health records at my institution now give us over 9 years of continuity. Even when I'm just meeting a patient for the first time, I can look back and see their first visit to the pediatric ED for asthma, the appendectomy from a few years ago, the gastritis visit during college break that may or may not have been related to alcohol.For older patients, I ca...
Source: Blogborygmi - December 31, 2012 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Free to decide
Describe electronic clinical decision support to someone outside of healthcare.They'll probably start conjuring images of Watson or Clippy - an automated guide who incorporates clinical data and provider habits, to offer suggestions to improve care.And yet, despite advances in computing power and machine learning, and a massive push to adopt electronic records, clinical decision support remains stuck - so primitive that even 90's-era Clippy seems wise and helpful in comparison.I think there are many culprits for this, but a big reason clinical decision support lags is that it's been hijacked by well-meaning hospital a...
Source: Blogborygmi - November 15, 2012 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
Something's always wrong
I had an idea for an absurd indie comic strip about Corrective Action Plans - those in-depth multi-departmental administrative remedies that are developed in response to bad outcomes, dropped balls, missed communications. Over time we've taken to calling them CAPs.The comic would follow the adventures of CAP'n America. He'd never arrive in time to save the day (in fact, he only worked business hours) but he would be sure to show up after a traffic accident or crime scene investigation and make sweeping pronouncements about how workflows will have to change.Wouldn't that make for funny reading?I still consider myself relati...
Source: Blogborygmi - September 25, 2012 Category: Emergency Medicine Doctors Authors: Nick Genes Source Type: blogs
