Portals

Edward Winslow edbjwinslow at GMAIL.COM
Mon Jul 8 23:42:35 UTC 2019


Ed,
This is likely to get us off on a tangent/diversion.  I agree with you that
C&P is at best counter productive and at worst gets in the way of thinking.
I have a story of C&P when I was a consultant.  A house officer wrote:
Plan: Call Dr. W for opinion regarding patient’s dyspnea.  i consulted
within 4 hours (they didn’t page or call). The next day the note read:
“Plan: Call ....” verbatim.  That went on for 5 days.  :-).
If people are doing C&P, the reason for the note - to encourage thinking
(and differential diagnosis).
This rant isn’t on the ability or patient portals getting in the way.  I
haven’t heard that they do.

On Mon, Jul 8, 2019 at 5:05 PM Edward Hoffer <ehoffer at gmail.com> wrote:

> This is a problem with the EMR rather than with portal.  Portal simply
> gives you a glimpse into part of what is in the EMR.  I have railed against
> the "cut-and-paste" school of record keeping that has become the fashion in
> all EMRs in my book and elsewhere to no avail.  After all "if the computer
> says so..."
> Ed
>
> On Mon, Jul 8, 2019 at 2:51 PM Koppel, Ross J <rkoppel at sas.upenn.edu>
> wrote:
>
>> Portals can come to hurt DX big time.  Patients bring in that info to
>> their docs and to the ED.   But I'm  working on a piece about my ten PHRs/
>> portals.   "My" data are totally gaga.  No relation of the
>> information to each other or to me.  Med I was on for 3 days (teeny,
>> tiny little tube for when I got something in my eye) has been a continuous
>> medication for 14 years.   Loaves and fishes from the ophthalmologist.    I
>> tried a PPI, then went to a lower one, then they became OTC...so I went to
>> that.  Then I tried a lower dose.  according to my PHR, I'm on all of them
>> all the time. According to my portals,   have not had stomach acid for 2 or
>> 3 decades; been dead that whole time too, I guess.
>>
>>
>> Ditto for the "problem lists"   No reality, no consistency.
>>
>>
>> Note that I'm a professor of biomed informatics at Penn and SUNY buffalo,
>> but  I can NOT get the wrong stuff removed.  I've tried.
>>
>>
>> Ross Koppel
>>
>>
>>
>> ------------------------------
>> *From:* Ed Hoffer <ehoffer at GMAIL.COM>
>> *Sent:* Monday, July 8, 2019 10:22 AM
>> *To:* IMPROVEDX at LIST.IMPROVEDIAGNOSIS.ORG
>> *Subject:* Re: [IMPROVEDX] Portals
>>
>> Portals are generally local systems allowing patients to access test
>> results and communicate with their doctors rather than being national. I am
>> sure they can be hacked but hard to see how they would contribute to
>> diagnostic error.
>> Ed
>> Edward P Hoffer MD
>>
>> Sent from my iPhone
>>
>> > On Jul 7, 2019, at 3:42 PM, ROBERT M BELL <
>> 0000000296e45ec4-dmarc-request at list.improvediagnosis.org> wrote:
>> >
>> > From time to time we hear about the problems of HCPs using computer
>> systems to communicate.
>> >
>> > There is another computer system in general use, namely the Portal to
>> help HCPs communicate with patients.
>> >
>> > Are there any reports of problems with this national system, and is
>> there any chance that it could contribute to error?
>> >
>> > Robert Bell, M.D.
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-- 
Edward B, J. Winslow, MD, MBA
Home 847 256-2475; Mobile 847 508-1442
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Theodore Roosevelt, 26th President of United States of America






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


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