[External Sender] Re: [IMPROVEDX] Tech Can Turn Doctors into Clerical Workers

Centor, Robert rcentor at UABMC.EDU
Sat May 19 19:54:30 UTC 2018


Until Electronic Health Record developers reimagine their products from a viewpoint of the health professionals, they will not improve.  Current EHRs are designed to facilitate billing.

Often policy wonks want to compare medicine to the airline industry.  The computerization of the cockpit is designed solely to help the pilots.  This never has happened with our electronic charts.

The unintended consequences of our current records are legion.  Your optimistic take on electronic records remains aspirational.  We agree on the goal and possibilities but we will need a dramatic change to current programs to achieve what you propose.

==============

Robert M Centor, MD, MACP

Chair-Emeritus, ACP Board of Regents

Professor-Emeritus
General Internal Medicine
UAB
FOT 720
1530 3rd Ave S
Birmingham, AL 35294-3407


From: Art Papier <apapier at VISUALDX.COM<mailto:apapier at VISUALDX.COM>>
Reply-To: Society to Improve Diagnosis in Medicine <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>, Art Papier <apapier at VISUALDX.COM<mailto:apapier at VISUALDX.COM>>
Date: Saturday, May 19, 2018 at 2:39 PM
To: "IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>" <IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>>
Subject: [External Sender] Re: [IMPROVEDX] Tech Can Turn Doctors into Clerical Workers

It is a wonderful piece, but we need to be precise and not conflate “tech” with the “EHR”.  I have not heard anyone ask for their 4 lb PDR back and say they hate Epocrates.  I have not heard doctors complain about digital radiography, and wish to go back to hanging film on radiology alternators.  Beyond the EHR there are wonderful technology applications that save us time, and help us to deliver better care.  Searching a database with the patient to answer their question will actually communicate to the patient that you care enough to pause, and to look up information about their unique question.  Doing the opposite and blowing off their question can damage the physician patient relationship.   Shooting from the hip and not looking up evidence when it is available can actually be harmful.  Yes to listening to patients and to engaging in their lives.  Yes to thorough physical exams.  But let’s not go back to the paradigm of doctor as all knowing oracle operating from their brain alone, let’s envision a future state where technology can guide people and their clinicians to deliver the best possible knowledge to the decision making moment.
The problem is the failure to create an EHR that guides and enhances clinical thinking.
It is not tech, it is doctors slaving to a billing and bureaucratic compliance system called the EHR.  First step is to rid ourselves of fee for service medicine and then the EHR will begin to improve.

Art Papier MD
CEO VisualDx
Associate Professor Dermatology and Medical Informatics
University of Rochester

From: Mark Graber <Mark.Graber at IMPROVEDIAGNOSIS.ORG<mailto:Mark.Graber at IMPROVEDIAGNOSIS.ORG>>
Sent: Saturday, May 19, 2018 12:06 AM
To: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>
Subject: [IMPROVEDX] Tech Can Turn Doctors into Clerical Workers

An insightful and troubling, editorial<https://urldefense.proofpoint.com/v2/url?u=https-3A__nyti.ms_2GlkYCs&d=DwMGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=VDbQTiayqkR-45EdQX1jXrn3edGGPd4aQUfg_vJgCro&e=> by Abraham Verghese looks at “How Tech Can Turn Doctors into Clerical Workers”.  This is a great read, with one of the best illustrations you will ever see.

Mark L Graber MD FACP
President, SIDM
Senior Fellow, RTI International
Professor Emeritus, Stony Brook University
[cid:image002.jpg at 01D3EF85.FD0B4760]

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1<https://urldefense.proofpoint.com/v2/url?u=http-3A__list.improvediagnosis.org_scripts_wa-2DIMPDIAG.exe-3FSUBED1-3DIMPROVEDX-26A-3D1&d=DwMGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=kDZdz9xg3Tr84qtKxLu3PbgKnx1AWq_cvBJI-ZQkvPo&e=>
or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX<https://urldefense.proofpoint.com/v2/url?u=http-3A__list.improvediagnosis.org_scripts_wa-2DIMPDIAG.exe-3FINDEX&d=DwMGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=6FuHP_llN-fr_W-E5bv0txPJqQiLBfSbHYdbXkgqjDM&e=>

Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.improvediagnosis.org_&d=DwMGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=z0xfpeyOl4zo-xzUWt9IDIQqTw6Iw5ADCO05Wr8aa0Q&e=>

________________________________

Address messages to: IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG>

To unsubscribe from IMPROVEDX: click the following link:
http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?SUBED1=IMPROVEDX&A=1<https://urldefense.proofpoint.com/v2/url?u=http-3A__list.improvediagnosis.org_scripts_wa-2DIMPDIAG.exe-3FSUBED1-3DIMPROVEDX-26A-3D1&d=DwMGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=kDZdz9xg3Tr84qtKxLu3PbgKnx1AWq_cvBJI-ZQkvPo&e=>

or send email to: IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG<mailto:IMPROVEDX-SIGNOFF-REQUEST at LIST.IMPROVEDIAGNOSIS.ORG>

Visit the searchable archives or adjust your subscription at: http://list.improvediagnosis.org/scripts/wa-IMPDIAG.exe?INDEX<https://urldefense.proofpoint.com/v2/url?u=http-3A__list.improvediagnosis.org_scripts_wa-2DIMPDIAG.exe-3FINDEX&d=DwQGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=6FuHP_llN-fr_W-E5bv0txPJqQiLBfSbHYdbXkgqjDM&e=>

Moderator:David Meyers, Board Member, Society for Improving Diagnosis in Medicine

To learn more about SIDM visit:
http://www.improvediagnosis.org/<https://urldefense.proofpoint.com/v2/url?u=http-3A__www.improvediagnosis.org_&d=DwQGaQ&c=o3PTkfaYAd6-No7SurnLtwPssd47t-De9Do23lQNz7U&r=lKOUSI1VbcdcWs5U5oqgToSe5axVTFObfPeLZyyqVcM&m=sd4Pq6ihDDvz-GBVc7c7hqSilSmHHJZ8ho6FlMiLNdE&s=z0xfpeyOl4zo-xzUWt9IDIQqTw6Iw5ADCO05Wr8aa0Q&e=>






Moderator: David Meyers, Board Member, Society to Improve Diagnosis in Medicine


HTML Version:
URL: <../attachments/20180519/b33af1a2/attachment.html> ATTACHMENT:
Name: image002.jpg Type: image/jpeg Size: 3074 bytes Desc: image002.jpg URL: <../attachments/20180519/b33af1a2/attachment.jpg>


More information about the Test mailing list