An ongoing dialogue on HIV/AIDS, infectious diseases,
May 14th, 2017
Poll: Which Feature of Electronic Health Records is Most Important to Patient Care?
The first electronic medical record I used regularly — called “BICS” — initially had one purpose. It was a tool to look up a patient’s lab results. Simple, reliable, and blazingly fast, it did one thing remarkably well. Later, one of our Emergency Department doctors, who happens to have impressive coding skills, worked with a team to add a simple ambulatory medical […]
April 30th, 2016
A Ridiculously Long Post: How EHRs Expose Unspoken Hierarchies Within Medicine — Or Maybe Are Just Bad
I am consulted by a surgeon about a patient with something that might be infectious, might not. A very appropriate referral. After seeing the patient and reviewing the history and scans, I decide a CT-guided biopsy is the next step. The nice radiology fellow tells me “Just place the order in [enter name of EHR here]”. Since this is the first time […]
December 6th, 2015
Do Electronic Health Records Make You a Better (or Worse) Clinician?
Earlier this week, JAMA Internal Medicine published a study entitled, “Level of Computer Use in Clinical Encounters Associated with Patient Satisfaction”. A more descriptive title would have been “More Computer Use in Clinical Encounters Associated with Reduced Patient Satisfaction”, as here’s the take home point: High computer use by clinicians in safety-net clinics was associated with lower patient satisfaction […]
September 20th, 2015
EHR and Drug Prescribing Warnings: The Good, the Bad, the Ugly
Part 1. The Good. Recently, an ENT colleague (fictionally named “Clint” below), sent me two emails triggered by drug-drug interaction warnings he received while seeing HIV patients. Here’s #1: Hey Paul, I saw Mark C yesterday for hoarseness, and his exam was negative. Thought we’d try a PPI for reflux, but when I wrote the script, I […]