tag:blogger.com,1999:blog-7047155484025790084.comments2019-12-30T08:19:53.509-05:00Accelerating Adoption of Healthcare ITMichael Finkehttp://www.blogger.com/profile/08538125054249508136noreply@blogger.comBlogger33125tag:blogger.com,1999:blog-7047155484025790084.post-57933561811234019262010-03-23T18:49:12.736-04:002010-03-23T18:49:12.736-04:00Thanks for your comment - yes I have and a range o...Thanks for your comment - yes I have and a range of experiences. Medicine was never designed with technology in mind and we are having a hard time retrofitting some technology into a busy clinical practice. I remember being shown an early system a number of years ago that took ~20 clicks to enter a BP of 120/80....fail!<br />That said we need technology to help support the ever more complex world of healthcare and must find innovative ways to incorporate it into our clincal practiceNick van Terheyden, MDhttps://www.blogger.com/profile/01270535756215052927noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-6347434542518005942010-03-22T16:41:49.911-04:002010-03-22T16:41:49.911-04:00This is a really interesting blog. You know, as a ...This is a really interesting blog. You know, as a lay person I see doctors using new technology and a lot of the time it seems cumbersome and difficult to use. Have you personally used software like you talk about in this post to manage patient care? How did it work for you?<br /><br />-Aurora<br />http://www.socialmditv.wordpress.comAurorahttp://twitter.com/mditvorgnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-81187987939251192532009-11-26T08:17:42.690-05:002009-11-26T08:17:42.690-05:00I would love to be the "scribe" for some...I would love to be the "scribe" for some docs! I've been a transcriptionist for 22 years and an editor for the last 2. It would be great to actually capture their visit with the patient in real time, without the usual problems of a doc's dictation.Cary Deshazernoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-69563893402721018402009-11-22T23:52:51.357-05:002009-11-22T23:52:51.357-05:00(sheepishly) I told this story to an ophthalmologi...(sheepishly) I told this story to an ophthalmologist Friday. He said one of his colleagues has been very happy with using a scribe in his practice, that it has allowed him to see more patients. Go figure.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-18032795063948822112009-11-22T04:12:01.760-05:002009-11-22T04:12:01.760-05:00The inefficiency and un-scalability of this soluti...The inefficiency and un-scalability of this solution is almost mind boggling. A one-to-one match between physician and "scribe"? Really, rather funny considering that hospitals have been using technology to eliminate transcription costs - who is paying for the scribes? What we're hearing is even more evidence that technology such as speech understanding or speech recognition, when coupled with a skilled medical transcription editor, is a viable, cost efficient way to allow physicians to capture clinical information while keeping their attention where it belongs - on the patient.Anonymoushttps://www.blogger.com/profile/03153680437638826251noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-71963014845632196862009-11-19T22:58:42.567-05:002009-11-19T22:58:42.567-05:00I can see problems with the scribe concept (and I&...I can see problems with the scribe concept (and I'm a double UVa grad myself). The doc is the one who (thinks she) knows what is important to capture. Most docs don't even review their own transcribed records. For them to take the time to review what will probably be even longer scribe records would add a huge amount of wasted time. And we haven't even talked about who pays the scribe how much. It's yet another HIPAA question. Scribes will certainly be regulated like everyone else in medicine. They will require certification; standards must be developed. Medical documentation is a moving target. The sad thing is the degree to which it is driven by attempts to document what the doc will need to defend against a malpractice suit where it should serve to enhance clinical pursuits.moviedochttps://www.blogger.com/profile/03617061594621924756noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-88771473820767114602009-11-18T17:13:06.718-05:002009-11-18T17:13:06.718-05:00An interesting commentary on the use of scribes in...An interesting commentary on the use of scribes in a local hospital that added 20 - 25% efficiency for this Emergency Room Doctor<br />http://emergencydocs.wordpress.com/2009/11/06/science-vs-the-art-of-medicine-and-the-use-of-medical-scribes/trackback/Nick van Terheyden, MDhttps://www.blogger.com/profile/01270535756215052927noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-61502330155300382812009-11-12T07:23:50.493-05:002009-11-12T07:23:50.493-05:00Speech rec has come far, but it will NEVER replace...Speech rec has come far, but it will NEVER replace experienced personnel, such as transcriptionists. With the advent of speech rec, it was believed that it would replace coders as well. But that is slowly becoming evident that you cannot do without humans verifying the contents. Unfortunately, that finds our doctors sitting at monitors instead of having time to chat with their patients. The whole process still needs a lot of refining.Skyehttps://www.blogger.com/profile/09157488838281656388noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-45316300629822648082009-11-09T14:03:42.824-05:002009-11-09T14:03:42.824-05:00The hardware requirements have been significant bu...The hardware requirements have been significant but hardware has improved dramatically and average configurations can be used. Server side versions do off load the heavy lifting to a data center and can improve the results both from a response as well as performance (due to the constant tuning and improvement carried out in the data center).<br />The technology is not perfect but it has reached a point that delivers results back that offer savings in time and resourcesNick van Terheyden, MDhttps://www.blogger.com/profile/01270535756215052927noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-80857486798887951362009-11-09T13:31:54.357-05:002009-11-09T13:31:54.357-05:00I believe what is misleading about speech recognit...I believe what is misleading about speech recognition is the hardware requirements that are needed. I did server side speech recognition and this seems to be the most viable option for successful and near perfect text.Anonymoushttps://www.blogger.com/profile/04868721607770789826noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-70227778052264727852009-11-09T02:49:54.495-05:002009-11-09T02:49:54.495-05:00Exactly, if you are on screen, then only you can d...Exactly, if you are on screen, then only you can do is just listen the symptoms and what the patient actually says and what he demands, but the real diagnosis is done only at that time when the patient is in front and then the checking is done..<br /><br /><a href="http://www.zippy-health.com" rel="nofollow">current health news articles</a>Janehttps://www.blogger.com/profile/08586791369448549702noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-24265263516519702212009-11-06T04:58:02.047-05:002009-11-06T04:58:02.047-05:00Yet its not complete... let the imagination and ef...Yet its not complete... let the imagination and efforts drive crazy to come out with the outlandish results for happening and to hit on the prime time. Definitely as this technique fulfills its demand, it will rocks and a great revolution in the health care industry will be done.health carehttp://zippy-health.comnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-78860150413371428452009-10-30T21:51:07.930-04:002009-10-30T21:51:07.930-04:00Thats really a great blog. You have emphasized th...Thats really a great blog. You have emphasized the right thing at the right time (when President Obama is in full gear towards implementing EMR ... http://www.reuters.com/article/pressRelease/idUS147672+04-Jun-2009+MW20090604)Chapsyhttps://www.blogger.com/profile/13904524766430516815noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-15109566660928498272009-09-18T16:40:10.220-04:002009-09-18T16:40:10.220-04:00Winston Churchill, 1948 on his support of creating...Winston Churchill, 1948 on his support of creating the NHS.<br /><br />"The discoveries of healing science must be the inheritance of all. That is clear. Disease must be attacked, whether it occurs in the poorest or the richest man or woman simply on the ground that it is the enemy; it must be attacked just in the same way as the fire brigade will give its full assistance to the humblest cottage as readily as to the most important mansion. Our policy is to create a national health service in order to insure that everybody in the country, irrespective of means, age, sex, or occupation shall have equal opportunity to benefit from the best and most up-to-date medical and allied services available."Sandyhttp://obama-mamas.comnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-14559642421917025842009-08-31T20:52:55.795-04:002009-08-31T20:52:55.795-04:00Nick, you are correct. Having access to quality in...Nick, you are correct. Having access to quality information is only the first step. The next step is to find the information you need - like searching for a needle in a haystack sometimes.<br /><br />I wrote about this on my blog recently in a series of posts "The Value of the Internet for Improving Healthcare." The specific post regarding the ever increasing body of knowledge can be found at http://www.myhealthtechblog.com/2009/08/part_3_internet_usability_and_access_of_healthcare_information.htmlDeborahhttps://www.blogger.com/profile/15494174579808436497noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-49305286722510880582009-08-31T16:50:40.008-04:002009-08-31T16:50:40.008-04:00Finding ways to link narrative to ontology and ter...Finding ways to link narrative to ontology and terminology standards has always been one of our main issues (http://blog.icmcc.org/2008/05/05/terminology-2/) and is one of reasons for the session on ontologies we organise at the ICMCC@WC2009 event (http://2009.icmcc.org/ontology/).<br /><br />Lodewijk Bos<br />ICMCCLodewijk Boshttps://www.blogger.com/profile/14153407517457351035noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-19496479828226051692009-07-20T14:58:50.116-04:002009-07-20T14:58:50.116-04:00Thanks for the mention in your blog post, Dr. Nick...Thanks for the mention in your blog post, Dr. Nick. And thanks for continuing to beat the drum for the need for human intelligence as part of the equation for accurate healthcare documentation.Jay Vance, CMT, CHPhttps://www.blogger.com/profile/07813184044347319872noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-29381131596976559862009-06-17T21:09:48.133-04:002009-06-17T21:09:48.133-04:00Thanks for your comments -you make good points
The...Thanks for your comments -you make good points<br />The term YMMV (your mileage may vary) comes to mind. You can put technology or any tool in the hands anyone's hands - it is the intelligent use that is important. There are some elements of displaying information that can contribute and the concept of you the patient controlling and managing and correcting information might also help (this btw is not without challenges and resistance on the part of the medical profession) <br /><br />The discrimination you talk about is a real concern but to be honest I thin that is already going on. Obtaining insurance with "pre-existing conditions" is a real challenge. I agree we need to watch this area closely and it remains an increasing concern especially as you factor in genetic testing.Nick van Terheyden, MDhttps://www.blogger.com/profile/01270535756215052927noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-59511407789186967502009-06-17T20:16:16.688-04:002009-06-17T20:16:16.688-04:00Are emr's really better for the patient? If yo...Are emr's really better for the patient? If you go to the hospital and the genius attending attributes your symptoms to anxiety, then every Doc you go to in the future will see that and dismiss your symptoms as anxiety related. Chest pain?....well he has a history of anxiety......<br />Also, when companies figure out a way to pay for this info...legal or not...then it will be used to discriminate against you. Bank loan?....wait a minute he has a history of cancer....life insurance?....same thing. Job interview?....don't want her, she had a breast lump removed.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-29490474159687809382009-06-06T10:21:06.123-04:002009-06-06T10:21:06.123-04:00Thanks for today's blog. I can totally relate ...Thanks for today's blog. I can totally relate to what you wrote in your recent blog and to your child's sentiments. Been there, done that, and promptly switched to a new physician! My current physician pushes her laptop into the room for every patient and enters information into the EMR. However, the difference is that she has also mastered being able to balance inputting information, writing prescriptions, etc., with listening and addressing the issues of the patient. She makes eye contact. She pays attention when you are speaking to her. She really recognizes the necessity of interacting with the patient and showing that she cares and is here for them. People want to be heard and validated. Hopefully more physicians will take notice and apply these principles. And patients need to speak up too.Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-7116096924320779172009-06-05T00:52:13.501-04:002009-06-05T00:52:13.501-04:00Yes! Your 10-year-old's experience mirrored m...Yes! Your 10-year-old's experience mirrored mine with a local clinic. My son and I went in for help with a relapsed, hard-hitting respiratory malady that was going around our community. We watched the doctor keyboard information, left with NO help, and a hefty bill.<br /><br />My friend went to her doctor for the same malady, received traditional face-to-face care, came out with a prescription, and recovered from her bout of illness 2 or 3 times faster than our family did.Kristyhttps://www.blogger.com/profile/14530719752253973093noreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-30333283683154687572009-06-04T12:00:53.705-04:002009-06-04T12:00:53.705-04:00Thanks for today's blog. I can totally relate ...Thanks for today's blog. I can totally relate to what you wrote in your recent blog and to your child's sentiments. Been there, done that, and promptly switched to a new physician! My current physician pushes her laptop into the room for every patient and enters information into the EMR. However, the difference is that she has also mastered being able to balance inputting information, writing prescriptions, etc., with <i>listening and addressing the issues of the patient</i>. She makes eye contact. She pays attention when you are speaking to her. She really recognizes the necessity of interacting with the patient and showing that she cares and is here for them. People want to be heard and validated. Hopefully more physicians will take notice and apply these principles. And patients need to speak up too.Kristinnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-16287453535615496042009-04-30T16:40:00.000-04:002009-04-30T16:40:00.000-04:00Very interesting and educative article, I complete...Very interesting and educative article, I completely agree with it, thanks.<br /><br />Andy Press<br />http://www.angelspeech.comandy presshttp://www.angelspeech.comnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-9277081471948715582009-04-20T12:43:00.000-04:002009-04-20T12:43:00.000-04:00During our annual event ICMCC@WC2009, we will have...During our annual event <A HREF="http://2009.icmcc.org" REL="nofollow">ICMCC@WC2009</A>, we will have a session on ontology, semantics and EHR, also specifically covering aspects concerning the narrative.<br />Lodewijk BosLodewijk Boshttp://www.icmcc.orgnoreply@blogger.comtag:blogger.com,1999:blog-7047155484025790084.post-25573249538839732892009-03-25T13:00:00.000-04:002009-03-25T13:00:00.000-04:00Thanks Bob - these are great points and important ...Thanks Bob - these are great points and important to consider as part of the process of moving to a new technology.<BR/>There must be ways to mitigate the risk while transitioning to SR and allow for the variation between MLS.Nick van Terheyden, MDhttps://www.blogger.com/profile/01270535756215052927noreply@blogger.com